Excision of Giant Cell Tumor in Distal Radius Plus Reconstruction With Proximal Fibula Autograft and Osteosynthesis: Case Report

Abstract Giant cell tumor is a benign bone tumor, accounting for 3–5% of primary bone tumors in adults. The distal radius is the third most frequent location, and due to its high probability of complications and recurrences, it remains one of the most controversial tumors. We present the case of a 22-year-old male patient with no significant medical history, who presented with a 6-month history of left wrist pain exacerbated after direct trauma. Physical examination revealed pain upon digital pressure and during active-passive mobilization maneuvers of the left radiocarpal joint. Simple anteroposterior and lateral radiographs of the left wrist showed a circular lytic lesion measuring 5 × 5 cm involving the epiphysis and distal diaphysis of the left radius. A biopsy of the distal radius confirmed the diagnosis of giant cell tumor. Resection of the distal end of the radius was performed, followed by osteotomy of the proximal 7 cm of the fibula. The autologous graft was subsequently fixed with an LCP locking compression plate, and arthrodesis of the radioulnar joint was carried out along with a Sauvé-Kapandji osteotomy at the distal ulna level. Good postoperative results were observed three months after surgery. Being a highly controversial tumor, there is great diversity in its management; however, recent studies have demonstrated that tumor resection followed by reconstruction using a vascularized or non-vascularized fibular autograft yields effective results.