Giant Cell Tumor of Talus: T-Construct Method of Bone Grafting

Abstract

Giant cell tumor (GCT) or osteoclastoma is a benign, locally aggressive tumor with a tendency to recur. Giant cell tumors typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and involvement of talus is rare. The authors present a case of GCT of the talar body in a 21-year-old man, which was diagnosed radiologically by the presence of a well-defined osteolytic lesion involving more than half of the talar body with thinning of the cortices. An intralesional curettage and chemical cauterization with phenol was done using a medial approach following an osteotomy of the medial malleolus for adequate exposure. Intraoperative frozen section of curetted tissue was sent and was reported as benign GCT. The residual cavity was packed with autologous corticocancellous bone grafts fashioned in a T-construct like manner. A protective cast was applied for a period of 2 months and patient was subsequently gradually mobilized to full weightbearing status. At 2-year follow-up, there was no clinical or radiologically evident signs of recurrence. There was good consolidation of the bone graft in the talus with no signs of collapse of the weightbearing articular surface. Levels of Evidence: Therapeutic, Level IV: Case Study