Is there a need for reconstruction after excision of the distal ulna for giant-cell tumour?

Giant cell tumour rarely involves the distal ulna; the literature has sporadic cases reported, and the need for reconstruction after distal ulnar resection remains controversial. The uncommon presentation often leads to diagnostic delays, and some of the cases reported have attained large sizes prior to diagnosis, leading' to procedures which range from soft tissue stabilization to bone graft reconstruction of the surgical defect. We analyzed our cases with specific reference to the need for additional reconstruction; the radiological and functional outcome of extraperiosteal distal ulna resection without reconstruction in 4 patients with giant cell tumour of the distal ulna was assessed at a mean follow-up of 9 years post surgical excision. In our experience there was no radiological evidence of recurrence, radioulnar convergence and ulnar translocation of the carpus. Functional outcome was graded as excellent in 3 and good in one patient. In conclusion, it could be suggested that there is no need for reconstruction after distal ulna resection for GCT as an adequate functional outcome is seen even in late diagnosed cases. Reconstructive procedures, which come at the cost of additional morbidity and complications, and requires special technical skills, are not routinely justified for this rare condition.