Ulnar translocation and wrist fusion in the management of giant cell tumour of the distal radius: an evaluation of three fixation methods.

Giant cell tumour (GCT) is a benign but locally aggressive bone tumour that affects the epiphyseal regions of long bones, with the distal radius involved in about 10% of cases. Treatment aims to completely remove the tumour, prevent recurrence and restore normal wrist and forearm function. However, traditional treatments such as curettage with adjuvants may leave the microscopic tumour cells, increasing the recurrence risk. When a GCT invades the joint and subchondral bone, preserving wrist anatomy becomes vital. Wide resection followed by reconstruction using structural grafts (like fibula), allografts or wrist arthrodesis reduces the recurrence but has limitations, such as poor grip and donor site morbidity. This case series presents a surgical approach combining wide resection, ulna translocation and wrist arthrodesis to maintain function and reduce recurrence. Three fixation techniques-a long plate, a 'T' plate and two small plates-were used and comparatively assessed for effectiveness. The outcomes were measured using the Mayo wrist score and the Musculoskeletal Tumor Society score.