Wrist Total Arthrodesis with Vascularized Fibula Graft in Bone Tumors of the Distal Radius

Abstract

Objectives: Reconstruction of the wrist after resection of distal forearm tumours involving the joint may often be difficult for surgeons. The aim of this study was to examine the clinical results of 5 patients on whom total wrist arthrodesis was performed with vascularised fibula graft (VFG) after tumour resection in the distal radius. Methods: A retrospective examination was made of 5 patients (4 males, 1 female) applied with wrist arthrodesis with VFG. The patients were evaluated in respect of defect amount after resection, the length of VFG used, time to bone healing, postoperative complications, reconstruction procedures, and forearm rotation. The postoperative clinical evaluation of the patients was made according to the Musculoskeletal Tumour Society (MSTS) score. Results: The resected distal radius segment of the patients was mean 7.05cm and the mean VFG length was 8.19cm. The diagnoses were malignant mesenchymal tumour in 2 patients, osteosarcoma, giant cell tumour, and chondrosarcoma in the other 3. Osseofasciacutaneous VFG was harvested in 4 patients and only osseous VFG in 1. Bone healing was observed radiologically in mean 4.6 months (range, 4-6 months) in all the patients. The mean MSTS sore at the final follow-up examination was 84%. Conclusion: When there is a bone defect involving the wrist joint, wrist arthrodesis applied with VFG is a useful and reliable reconstructive option that provides satisfactory results.