Surgical treatment of giant cell tumors in distal radius

Objective To compare the indications of giant cell tumor in distal radius for two different surgical procedures and their long-term therapeutic effects. Methods Twenty-one patients with giant cell tumor in distal radius admitted to our hospital from May 2004 to January 2010 were divided into group A and group B.The tumor was graded according to the Campanacci grading system.Patients in group A underwent curettage,adjuvant phenol therapy,and bone grafting.Patients in group B underwent en bloc resection of bone tumor with autologous fibula replacement.The patients were followed up after operation. Results The operation was successful for the 18 patients,all of them were followed up for an average period of 28 months（range 13-54 months）.The tumor recurred in 4 patients in group A with a recurrence rate of 36.4%.According to the Enneking functional evaluation system,excellent,good and fair outcome was achieved respectively in 3,5 and 3 patients with an excellent and good rate was 72.72%.The wrist motion range averaged 78°extension/flexion,35°radial/ulnar deviation.No patient in group B experienced local recurrence.According to the Enneking function evaluation system,excellent,good and fair outcome was achieved in 1,5 and 1 patients respectively with an excellent and good rate was 85.71%.The wrist motion range averaged 67°extension/flexion,30°radial/ulnar deviation. Conclusion The operation must be selected according to the Campanacci grading system.Although the average wrist motion range was lower in group B than in group A,the Enneking function was better in group A than in group B.Local recurrent rate can be decreased by en bloc resection of bone tumor with autologous fibula replacement and achieve a better wrist function when the case is at Campanacci stage Ⅲ or II with morbid fracture.