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DOI: 10.1055/s-0030-1249608
© Georg Thieme Verlag KG Stuttgart · New York
Rekonstruktion des distalen Radius mittels freiem mikrovaskulären Fibulatransplantat: 5-Jahres-Resultat nach en-bloc-Resektion eines Riesenzelltumors
Free Microvascular Fibula Graft for Skeletal Reconstruction of the Distal Radius: 5 Years Follow-up after en-bloc Resection of a Giant Cell TumourPublikationsverlauf
eingereicht 29.7.2009
akzeptiert 12.2.2010
Publikationsdatum:
05. Mai 2010 (online)
Zusammenfassung
Die histologisch gesicherte Diagnose eines Riesenzelltumors der Hand oder des Handgelenkes sollte wie ein niedriggradig malignes Tumorleiden behandelt werden. Eine tendenziell höhere Aggressivität, die Metastasierungs- und Lokalrezidivrate sowie die topografische Nähe zu den Leitungsbahnen machen ein sehr differenziertes chirurgisches Vorgehen erforderlich. Anhand des Falles einer 54-jährigen Patientin mit Riesenzelltumor der körperfernen Speiche des Stadiums III nach Campanacci werden die Behandlungsmöglichkeiten und Prinzipien des Riesenzelltumors dargestellt.
Abstract
A giant cell tumour of the distal radius or of the carpal bones, verified by incisional biopsies, should be approached as a low-grade malignancy. Lesions that arise in the bones of the hand or the wrist have a greater propensity to metastasise, and have a higher risk of local recurrence. In this case report we describe a 54-year-old women with a giant cell tumour of the distal radius (Campanacci grade III lesion), having a follow-up of five years without signs of local recurrence or metastatic disease. The general principles of and options for surgical treatment are discussed.
Schlüsselwörter
Tumor - Knochen - Riesenzelltumor - freies mikrovaskuläres Fibulatransplantat
Key words
tumour - bone - giant cell tumour - free microvascular fibula graft
Literatur
- 1 Campanacci M, Baldini N, Boriani S. et al . Giant-cell tumor of bone. J Bone Joint Surg [Am]. 1987; 69 106-114
- 2 Lackman RD, McDonald DJ, Beckenbaugh RD. et al . Fibular reconstruction for giant cell tumor of the distal radius. Clin Orthop Relat Res. 1987; 218 232-238
- 3 Murray JA, Schlafly B. Giant-cell tumors in the distal end of the radius. Treatment by resection and fibular autograft interpositional arthrodesis. J Bone Joint Surg [Am]. 1986; 68 687-694
- 4 Bickert B, Heitmann C, Germann G. Fibulo-scapho-lunate arthrodesis as a motion-preserving procedure after tumour resection of the distal radius. J Hand Surg [Br]. 2002; 27 573-576
- 5 Jacobs PA, Clemency Jr. RE. The closed cryosurgical treatment of giant cell tumor. Clin Orthop Relat Res. 1985; 192 149-158
- 6 Minami A, Kato H, Iwasaki N. Vascularized fibular graft after excision of giant-cell tumor of the distal radius: wrist arthroplasty versus partial wrist arthrodesis. Plast Reconstr Surg. 2002; 110 112-117
- 7 Athanasian EA, Wold LE, Amadio PC. Giant cell tumors of the bones of the hand. J Hand Surg [Am]. 1997; 22 91-98
- 8 O’Donnell RJ, Springfield DS, Motwani HK. et al . Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg [Am]. 1994; 76 1827-1833
- 9 Vander Griend RA, Funderburk CH. The treatment of giant-cell tumors of the distal part of the radius. J Bone Joint Surg [Am]. 1993; 75 899-908
- 10 Bertoni F, Present D, Sudanese A. et al . Giant-cell tumor of bone with pulmonary metastases. Six case reports and a review of the literature. Clin Orthop Relat Res. 1988; 237 275-285
- 11 Dahlin DC, Cupps RE, Johnson Jr EW. Giant-cell tumor: a study of 195 cases. Cancer. 1970; 25 1061-1070
- 12 Harness NG, Mankin HJ. Giant-cell tumor of the distal forearm. J Hand Surg [Am]. 2004; 29 188-193
- 13 Giessler GA, Bickert B, Sauerbier M. et al . Das freie mikrovaskuläre Fibulatransplantat zur Skelettrekonstruktion nach Tumorresektion am Unterarm - Erfahrungen aus fünf Fällen. Handchir Mikrochir Plast Chir. 2004; 36 301-307
- 14 Leung PC, Chan KT. Giant cell tumor of the distal end of the radius treated by the resection and free vascularized iliac crest graft. Clin Orthop Relat Res. 1986; 202 232-236
Korrespondenzadresse
Dr. Torsten Franz
Klinik für Plastische und
Hanchirurgie
Inselspital Bern
3010 Bern
Schweiz
eMail: torsten.franz@insel.ch