Treatment of giant cell tumor of the distal radius

The results of surgical treatment of giant cell tumors of the distal radius were reviewed in 12 patients between 1982 and 1995. All 12 patients had Grade III lesions. Six of the 12 patients were treated using intralesional curettage with local excision, and the other six patients underwent en bloc resection with total condyle (four of the six by osteoarticular allograft, and the other two by fibular autograft) reconstruction with the aim of preserving the functional joint. There were no early or late complications such as infection, graft fracture, implant failure, or nonunion. No local tumor recurrence was seen in either group during the average followup of 6 years (range, 3-16 years). The best functional result was seen in the patients treated with intralesional curettage. The functional result of the resection group was good, achieving an average of 69% (range, 56%-83%) of their range of motion and 70% (range, 63%-77%) of their grip strength on the contralateral side. Intralesional excision should not be excluded as a possible treatment of Grade III lesions, although en bloc resection was used more commonly for these lesions because of tumor surgery reasons. Grade III lesions were treated with curettage when the tumor did not invade the wrist, destroy more than 50% of the cortex, or break through the cortex with an extraosseous mass in more than one plane. Reconstruction with osteoarticular allograft after en bloc resection is recommended in this non-weightbearing joint when there is contraindication for curettage of the lesion.