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Year : 2017  |  Volume : 52  |  Issue : 3  |  Page : 226-229

A modified technique of reconstruction following excision of the distal ulna for giant cell tumor

1 Department of Orthopaedics and Trauma, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
2 Soba University Hospital, Faculty of Medicine, University of Khartoum, Khartoum, Sudan

Correspondence Address:
Samir Shaheen
Department of Orthopaedics and Trauma, Faculty of Medicine, University of Khartoum
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eoj.eoj_63_17

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Introduction Giant cell tumors (GCTs), though usually benign, can be aggressive and behave as a high-grade malignant neoplasm. They constitute 4–5% of primary bone tumor. Ulna is an uncommon site for affection. Treatment options range from curettage to radical excision. An effective treatment of GCT of the distal ulna is en-bloc resection, with significant risk of unstable wrist and ulnar stump. Patients and methods We present three patients with distal ulnar GCT, two males and one female. Their ages were 48, 26, and 20 years. After workup diagnosis, the tumor was resected en-bloc with safety margin, and the free ulnar stump was stabilized with one half of the tendon of extensor carpi ulnaris split longitudinally, one half left intact, and the other half detached from its insertion reflected back, threaded through a drill hole in the free ulnar stump redirected back and resutured to the intact half. In all three cases, the same technique was used. The technique was a modification from that described by Goldner and Hayes. Results All the three patients returned to normal activities at 6 weeks, and after a minimum follow-up of 9 months, they remain symptom free with full movements and function in the stable wrist. Conclusion The modification of the old technique has improved the biomechanics and function of the wrist and has stabilized the free ulna stump.

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