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Custom-made wrist prosthesis in a patient with giant cell tumor of the distal radius
Hans-Georg Damert1, Silke Altmann, Armin Kraus
1Department of Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University, Leipziger Strasse 44, Magdeburg, Germany.
Introduction:
Treatment for giant cell tumors of the distal radius is challenging when motion is to be preserved. As standard wrist prostheses typically do not achieve favorable results, we treated a 36-year-old man with giant cell tumor of the distal radius with a new, custom-made implant.
Methods:
A custom-made wrist prosthesis with a long shaft was designed according to the patient's X-ray findings. After complete tumor resection, the prosthesis was subsequently implanted into the distal radius without complications.
Results:
Two months after surgery, range of motion was 30°-0-25° for extension/flexion, 10°-0-5° for ulnar/radial abduction, 80°-0-0 for pronation/supination, complete range of motion for the fingers, and a grip strength of 6 kg. Two years after surgery, implant position was still correct and range of motion was 45°-0-10° for extension/flexion, 10°-0-20° for ulnar/radial abduction, and 80°-0-10° for pronation/supination. Grip strength was 16 kg, and DASH score was 25 compared to 39 before surgery. The patient returned to work as a craftsman.
Conclusion:
Custom-made wrist prostheses could become a practical option in patients with large defects of the distal radius who desire to preserve wrist motion.
