Journal of clinical orthopaedics and trauma · 2026
Side-to-side functional symmetry and radiographic stability after distal ulna resection with ECU tenodesis: A case series of grade III giant cell tumors.
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Dubepuria Amol, Joshi Tanmay, Dohare Navaneet, Choudhary Jyoti, Barik Sitanshu
Аннотация
BACKGROUND: Wide excision is the preferred treatment for Campanacci grade III distal ulna giant cell tumors (GCT), but may lead to ulnar stump instability. Extensor carpi ulnaris (ECU) tenodesis is proposed to improve stability, though its effect on functional symmetry and radiographic alignment remains unclear.
METHODS: This retrospective case series included eight patients treated with distal ulna resection and ECU tenodesis. Functional outcomes were assessed using wrist and forearm range of motion (ROM), Disabilities of the Arm, Shoulder and Hand (DASH), and Patient-Rated Wrist Evaluation (PRWE) scores at final follow-up. Side-to-side comparison with the contralateral limb was performed to evaluate functional symmetry. Radiographic assessment included lunate uncovering ratio and evaluation for radioulnar convergence.
RESULTS: At a mean follow-up of 4.4 years, patients demonstrated low disability scores (mean DASH 13.1 ± 2.5; PRWE 16.0 ± 4.6). The operated limb showed minimal reductions in flexion, extension, and ulnar deviation (approximately 2-4°) compared to the contralateral side; these differences are within expected measurement variability and are unlikely to be clinically meaningful. Pronation and supination were preserved, indicating near-symmetric forearm rotation. Radiographically, all patients maintained ulnocarpal alignment, with no evidence of radioulnar convergence or ulnar stump instability.
CONCLUSION: Wide excision with ECU tenodesis provides favorable functional outcomes with preservation of forearm rotational symmetry and radiographic stability following distal ulna resection for Campanacci grade III GCT. Although minor differences in wrist motion were observed, these did not translate into clinically meaningful impairment. ECU tenodesis was associated with favorable outcomes; however, larger comparative studies are required to define its role.
METHODS: This retrospective case series included eight patients treated with distal ulna resection and ECU tenodesis. Functional outcomes were assessed using wrist and forearm range of motion (ROM), Disabilities of the Arm, Shoulder and Hand (DASH), and Patient-Rated Wrist Evaluation (PRWE) scores at final follow-up. Side-to-side comparison with the contralateral limb was performed to evaluate functional symmetry. Radiographic assessment included lunate uncovering ratio and evaluation for radioulnar convergence.
RESULTS: At a mean follow-up of 4.4 years, patients demonstrated low disability scores (mean DASH 13.1 ± 2.5; PRWE 16.0 ± 4.6). The operated limb showed minimal reductions in flexion, extension, and ulnar deviation (approximately 2-4°) compared to the contralateral side; these differences are within expected measurement variability and are unlikely to be clinically meaningful. Pronation and supination were preserved, indicating near-symmetric forearm rotation. Radiographically, all patients maintained ulnocarpal alignment, with no evidence of radioulnar convergence or ulnar stump instability.
CONCLUSION: Wide excision with ECU tenodesis provides favorable functional outcomes with preservation of forearm rotational symmetry and radiographic stability following distal ulna resection for Campanacci grade III GCT. Although minor differences in wrist motion were observed, these did not translate into clinically meaningful impairment. ECU tenodesis was associated with favorable outcomes; however, larger comparative studies are required to define its role.