Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius

ARMANGİL, Mehmet; YOĞUN, Yener; GEZER, Mehmet Can; KARACA, Mustafa Onur; BİLGİN, Sırrı Sinan; Bezirgan, Uğur

doi:10.5455/handmicrosurg.144262

Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius

Yener YOĞUN, (Ortopedi ve Travmatoloji Anabilim Dalı, El Cerrahisi Ünitesi, Ankara Üniversitesi Tıp Fakültesi, Ankara, Türkiye)

Uğur BEZİRGAN, (Ortopedi ve Travmatoloji Anabilim Dalı, El Cerrahisi Ünitesi, Ankara Üniversitesi Tıp Fakültesi, Ankara, Türkiye)

Mustafa Onur KARACA, (Ortopedi ve Travmatoloji Anabilim Dalı, Ankara Üniversitesi Tıp Fakültesi, Ankara, Türkiye)

Mehmet Can GEZER, (Ortopedi ve Travmatoloji Anabilim Dalı, Ankara Üniversitesi Tıp Fakültesi, Ankara, Türkiye)

Sırrı Sinan BİLGİN, (Ortopedi ve Travmatoloji Anabilim Dalı, Özel Muayenehane, El Cerrahisi, Ankara, Türkiye)

Mehmet ARMANGİL (Ortopedi ve Travmatoloji Anabilim Dalı, El Cerrahisi Ünitesi, Ankara Üniversitesi Tıp Fakültesi, Ankara, Türkiye)

Hand and Microsurgery

5 2

Yıl: 2023 Cilt: 12 Sayı: 1 Sayfa Aralığı: 23 - 29 Metin Dili: İngilizce DOI: 10.5455/handmicrosurg.144262 İndeks Tarihi: 24-07-2023

Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius

Öz:

Objectives: Reconstruction of the wrist after resection of distal forearm tumours involving the joint may often be difficult for surgeons. The aim of this study was to examine the clinical results of 5 patients on whom total wrist arthrodesis was performed with vascularised fibula graft (VFG) after tumour resection in the distal radius. Methods: A retrospective examination was made of five patients (four males, one female) applied with wrist arthrodesis with VFG. The patients were evaluated in respect of defect amount after resection, the length of VFG used, time to bone healing, postoperative complications, reconstruction procedures, and forearm rotation. The postoperative clinical evalua- tion of the patients was made according to the Musculoskeletal Tumour Society (MSTS) score. Results: The resected distal radius segment of the patients was mean 7.05 cm and the mean VFG length was 8.19 cm. The diagnoses were malignant mesenchymal tumour in two patients, osteosarcoma, giant cell tumour, and chondrosarco- ma in the other three patients. Osseofasciocutaneous VFG was harvested in four patients and only osseous VFG in one patient. Bone healing was observed radiologically in mean 4.6 months (range, 4-6 months) in all the patients. The mean MSTS score at the final follow-up examination was 84%. Conclusion: When there is a bone defect involving the wrist joint, wrist arthrodesis applied with VFG is a useful and relia- ble reconstructive option that provides satisfactory results.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Kawamura K, Yajima H, Kobata Y, Murata K, Shigematsu K, Maegawa N, et al. Wrist arthrodesis with vascularized fibular grafting. J Reconstr Mi- crosurg 2009;25:501-5.
2. Harness NG, Mankin HJ. Giant-cell tumor of the distal forearm. J Hand Surg Am 2004;29:188–93.
3. Salunke AA, Shah J, Warikoo V, Chakraborty A, Pokharkar H, Chen Y, et al. Giant cell tumor of distal radius treated with ulnar translocation and wrist arthrodesis. J Orthop Surg (Hong Kong) 2017;25:2309499016684972.
4. McGough RL, Rutledge J, Lewis VO, Lin PP, Yas- ko AW. Impact severity of local recurrence in gi- ant cell tumor of bone. Clin Orthop Relat Res 2005;438:116–22.
5. Ichihara S, Hidalgo-Diaz JJ, Facca S, Liverneaux P. Unicompartmental isoelastic resurfacing prosthe- sis for malignant tumor of the distal radius: A case report with a 3-year follow-up. Orthop Traumatol Surg Res 2015;101:969–71.
6. Mavrogenis AF, Galanopoulos J, Vottis C, Mega- loikonomos PD, Palmerini E, Kokkalis ZT. Oste- oarticular allograft reconstruction for an Angio- sarcoma of the distal radius. J Long Term Eff Med Implants 2016;26:79-87.
7. Liu W, Wang B, Zhang S, Li Y, Hu B, Shao Z. Wrist reconstruction after En bloc resection of bone tumors of the distal radius. Orthop Surg 2021;13:376–83.
8. Sheth DS, Healey JH, Sobel M, Lane JM, Marcove RC. Giant cell tumor of the distal radius. J Hand Surg Am 1995;20:432–40.
9. Higuchi T, Yamamoto N, Hayashi K, Takeuchi A, Abe K, Taniguchi Y, et al. Successful joint pres- ervation of distal radius osteosarcoma by en bloc tumor excision and reconstruction using a tumor bearing frozen autograft: a case report. BMC Surg 2018;18:12.
10. Saini R, Bali K, Bachhal V, Mootha AK, Dhillon MS, Gill SS. En bloc excision and autogenous fib- ular reconstruction for aggressive giant cell tumor of distal radius: a report of 12 cases and review of literature. J Orthop Surg Res 2011;6:1–9.
11. Ring D, Jupiter JB, Toh S. Transarticular bony defects after trauma and sepsis: arthrodesis using vascularized fibular transfer. Plast Reconstr Surg 1999;104:426–34.
12. Claxton MR, Shirley MB, Bakri K, Rose PS, Moran SL, Houdek MT. Utility of the free vascularized fibula flap to reconstruct oncologic defects in the upper extremity. Anticancer Res 2020;40:2751–5.
13. Taniguchi Y, Yoshida M, Doi N, Tamaki K, Tamaki T. Vascularized fibular osteocutaneous grafts in the treatment of severely infected wrist arthritis. J Re- constr Microsurg 2002;18:71–6.
14. Qu H, Guo W, Li D, Yang Y, Wei R, Xu J. Function- al results of wrist arthrodesis versus arthroplasty with proximal fibula following giant cell tumour excision of the distal radius. J Hand Surg (European Vol 2019;44:394–401.
15. Jaminet P, Rahmanian Schwarz A, Pfau M, Nus- che A, Schaller H, Lotter O. Fibulo scapho lu- nate arthrodesis after resection of the distal radi- us for giant cell tumor of the bone. Microsurgery 2012;32:458–62.
16. Peng-Fei S, Yu-Hua J. Reconstruction of distal ra- dius by fibula following excision of grade III giant cell tumour: follow-up of 18 cases. Int Orthop 2011;35:577–80.
17. Houdek MT, Wagner ER, Bishop AT, Shin AY, Rose PS, Sim FH, et al. Complications and Long-Term Outcomes of Free Fibula Reconstruction follow- ing Resection of a Malignant Tumor in the Extrem- ities. Plast Reconstr Surg 2017;139:510e-519e.
18. Eward WC, Kontogeorgakos V, Levin LS, Brigman BE. Free vascularized fibular graft reconstruction of large skeletal defects after tumor resection. Clin Orthop Relat Res 2010;468:590–8.
19. Landau MJ, Badash I, Yin C, Alluri RK, Patel KM. Free vascularized fibula grafting in the operative treatment of malignant bone tumors of the upper extremity: A systematic review of outcomes and complications. J Surg Oncol 2018;117:1432–9.
20. Hilven PH, Bayliss L, Cosker T, Dijkstra PD, Jutte PC, Lahoda LU, et al. The vascularised fibular graft for limb salvage after bone tumour surgery: a mul- ticentre study. Bone Joint J 2015;97-B:853-61.
21. Chen CM, Disa JJ, Lee HY, Mehrara BJ, Hu QY, Nathan S, et al. Reconstruction of extremity long bone defects after sarcoma resection with vascular- ized fibula flaps: a 10-year review. Plast Reconstr Surg 2007;119:915-24.
22. Gebert C, Hillmann A, Schwappach A, Hoffmann Ch, Hardes J, Kleinheinz J, et al. Free vascularized fibular grafting for reconstruction after tumor resection in the upper extremity. J Surg Oncol 2006;94:114-27.

APA	YOĞUN Y, Bezirgan U, KARACA M, GEZER M, BİLGİN S, ARMANGİL M (2023). Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. , 23 - 29. 10.5455/handmicrosurg.144262
Chicago	YOĞUN Yener,Bezirgan Uğur,KARACA Mustafa Onur,GEZER Mehmet Can,BİLGİN Sırrı Sinan,ARMANGİL Mehmet Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. (2023): 23 - 29. 10.5455/handmicrosurg.144262
MLA	YOĞUN Yener,Bezirgan Uğur,KARACA Mustafa Onur,GEZER Mehmet Can,BİLGİN Sırrı Sinan,ARMANGİL Mehmet Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. , 2023, ss.23 - 29. 10.5455/handmicrosurg.144262
AMA	YOĞUN Y,Bezirgan U,KARACA M,GEZER M,BİLGİN S,ARMANGİL M Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. . 2023; 23 - 29. 10.5455/handmicrosurg.144262
Vancouver	YOĞUN Y,Bezirgan U,KARACA M,GEZER M,BİLGİN S,ARMANGİL M Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. . 2023; 23 - 29. 10.5455/handmicrosurg.144262
IEEE	YOĞUN Y,Bezirgan U,KARACA M,GEZER M,BİLGİN S,ARMANGİL M "Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius." , ss.23 - 29, 2023. 10.5455/handmicrosurg.144262
ISNAD	YOĞUN, Yener vd. "Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius". (2023), 23-29. https://doi.org/10.5455/handmicrosurg.144262

APA	YOĞUN Y, Bezirgan U, KARACA M, GEZER M, BİLGİN S, ARMANGİL M (2023). Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. Hand and Microsurgery, 12(1), 23 - 29. 10.5455/handmicrosurg.144262
Chicago	YOĞUN Yener,Bezirgan Uğur,KARACA Mustafa Onur,GEZER Mehmet Can,BİLGİN Sırrı Sinan,ARMANGİL Mehmet Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. Hand and Microsurgery 12, no.1 (2023): 23 - 29. 10.5455/handmicrosurg.144262
MLA	YOĞUN Yener,Bezirgan Uğur,KARACA Mustafa Onur,GEZER Mehmet Can,BİLGİN Sırrı Sinan,ARMANGİL Mehmet Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. Hand and Microsurgery, vol.12, no.1, 2023, ss.23 - 29. 10.5455/handmicrosurg.144262
AMA	YOĞUN Y,Bezirgan U,KARACA M,GEZER M,BİLGİN S,ARMANGİL M Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. Hand and Microsurgery. 2023; 12(1): 23 - 29. 10.5455/handmicrosurg.144262
Vancouver	YOĞUN Y,Bezirgan U,KARACA M,GEZER M,BİLGİN S,ARMANGİL M Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius. Hand and Microsurgery. 2023; 12(1): 23 - 29. 10.5455/handmicrosurg.144262
IEEE	YOĞUN Y,Bezirgan U,KARACA M,GEZER M,BİLGİN S,ARMANGİL M "Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius." Hand and Microsurgery, 12, ss.23 - 29, 2023. 10.5455/handmicrosurg.144262
ISNAD	YOĞUN, Yener vd. "Wrist total arthrodesis with vascularized fibula graft in bone tumors of the distal radius". Hand and Microsurgery 12/1 (2023), 23-29. https://doi.org/10.5455/handmicrosurg.144262