Graduate School of Tianjin Medical University, 154 Anshan Rd, Heping, Tianjin, 300070, China.
Affiliated Hospital of Hebei University of Engineering, 199 Guangming S St, Hanshan District, Handan, Hebei, 056004, China.
Hand Surg Rehabil. 2021 Apr;40(2):150-155. doi: 10.1016/j.hansur.2020.12.004. Epub 2021 Feb 13.
We aimed to evaluate the effectiveness of surgical methods commonly used for the clinical treatment of giant cell tumors (GCT) of the distal radius. From 2010 to 2018, 32 patients with GCT of the distal radius who underwent surgical treatment were eligible for the study. Among them, 21 patients with available pathological results, complete imaging data and at least 18 months of follow-up were enrolled in the study. Eleven of the patients underwent en bloc resection and non-vascularized autologous fibula reconstruction (Group A), while 10 patients underwent microwave ablation, lesion curettage, and internal fixation with bone cement (Group B). Imaging was carried out to understand the effect of the surgical treatment and postoperative complications. Variables of interested included operation time and blood loss, preoperative and postoperative wrist joint mobility, and postoperative complications during follow-up. The operation time and intraoperative blood loss in group A were higher than in group B, and the difference between groups was statistically significant. The wrist range of motion before and after surgery was statistically significant both in Group A and Group B (p < 0.05). The scale deviation and MSTS scores of group A were better than group B (p > 0.05), flexion, extension, radial deviation index in group B was better than group A (p < 0.05). By evaluating the postoperative functional outcomes of the operated wrist in the two groups, we found that both surgical methods are reliable for treating GCT of the distal radius, with satisfactory postoperative functional recovery and a low incidence of postoperative recurrence (only 1 of 10 patients in group B). The two surgical methods have their own advantages and disadvantages and provide surgeons with one more choice in the clinical context.
我们旨在评估常用于治疗桡骨远端骨巨细胞瘤（GCT）的手术方法的有效性。2010 年至 2018 年，32 例桡骨远端 GCT 患者接受了手术治疗，符合研究条件。其中，21 例患者具有可获得的病理结果、完整的影像学数据和至少 18 个月的随访，被纳入研究。11 例患者接受整块切除和非血管化自体腓骨重建（A 组），而 10 例患者接受微波消融、病灶刮除和骨水泥内固定（B 组）。进行影像学检查以了解手术治疗效果和术后并发症。感兴趣的变量包括手术时间和失血量、术前和术后腕关节活动度以及随访期间的术后并发症。A 组的手术时间和术中失血量均高于 B 组，组间差异具有统计学意义。A 组和 B 组术后腕关节活动度均有统计学意义（p<0.05）。A 组的尺偏角和 MSTS 评分均优于 B 组（p>0.05），B 组的屈、伸、桡偏指数均优于 A 组（p<0.05）。通过评估两组术后手术腕关节的功能结果，我们发现这两种手术方法治疗桡骨远端 GCT 均可靠，术后功能恢复满意，术后复发率低（B 组仅 1 例复发）。两种手术方法各有优缺点，为临床医生提供了更多的选择。
