[Total wrist fusion with vascularized fibula graft after tumor resection of the distal radius].

OBJECTIVE

Total tumor resection and defect resconstruction by vascularized fibula graft and total wrist fusion.

INDICATIONS: Primary extended bone tumors of the distal radius.

CONTRAINDICATIONS: Tumor infiltration of the whole carpus or of the neurovascular structures.

SURGICAL TECHNIQUE: En bloc resection of the tumor including the biopsy scar. Raising of a microvascular fibula graft including the peroneal vessels. Defect reconstruction using the fibula and stabilization of the total wrist fusion with a locking compression plate (LCP).

POSTOPERATIVE MANAGEMENT: Functional therapy of the fingers is possible, below elbow cast for 6 weeks. Weight bearing after 12 weeks according to bone healing.

RESULTS

The operation technique described for preservation of the extremity in primary extended bone tumors of the distal radius was performed in our clinic in 2 patients since 2009. Tumor-free and pain-free hand function was found at the 2.5-year follow-up examinations. The patients had free range of motion of the fingers and preserved sensorimotor function. The MSTS (Musculoskeletal Tumour Society) scores by Enneking were 80% and 70%.