Abstract

Background: Tumours in any part of the body requires one adequate removal of the tumour to prevent recurrence and second to give functionality. In surgical management of giant cell tumor (GCT), technique requires balance between functionality of joint and excision to prevent recurrence.

Case report

History: A 25 year old female presented with swelling and pain in left wrist joint (16 months). Biopsy was diagnosed as giant cell tumour (distal radius). Pre-operatively no dorsi flexion, palmar flexion, pronation or supinations were possible with any ulnar or radial deviation possible at wrist joint.

Procedure: In toto resection of the tumour along with removal of the distal third radius with adequate margin was ensured. Ulna was osteotomised at level of where radius was cut and ulna was transposed onto radius. At 4 months follow-up, patient was pain free and grip strength of operated hand was 80%. At 1yr follow up showed union of the radius and the ulna at site of osteotomy and union at the level of the crapus. Confirmed by radiographs of wrist and forearm showed incorporation of ulnar graft distally and proximally with maintenance of wrist position. Patient was able to do all her daily activities with the forearm with minimal restriction in daily activity of inability to lift heavy weights.

Conclusion: The case is highlighted for the technique of using the ulna to create a single bone forearm thereby producing a favourable functional outcome and avoidance of complications

Keywords: GCT; Radius; Tumour; Giant cell tumour