Some problems in wrist reconstruction after tumor resection with vascularized fibular-head graft. 1996

M Usui, and T Murakami, and T Naito, and T Wada, and T Takahashi, and S Ishii
Department of Orthopedic Surgery, Sapporo Medical University, Japan.

Restoration of wrist function was attempted in six patients with aggressive or malignant bone tumor of the distal end of the radius with free vascularized fibular graft including the fibular head, and following wide resection of tumor. There was no local recurrence in all six cases. In one case, pulmonary metastasis occurred, but was successfully treated. Secondary bone graft was necessary in two cases for non-union. Additional procedures, such as partial or total wrist fusion, were necessary in three cases due to collapse of the grafted fibular head. Corrective osteotomy or a Sauve-Kapandji procedure were also needed in two cases for improvement of forearm rotation. Grip strength ranged from 41 to 68 percent of the contralateral side, with an average of 54.6 percent in five cases; it was only 6 percent in one patient because of flexion contracture at the wrist joint. Final functional results, evaluated by a modified system of Enneking, ranged from 73 to 92 percent, with an average of 83.2 percent. Indications for this procedure seem to be limited to patients engaged in non-heavy manual work, in whom the proximal carpal row can be preserved during tumor resection, and who have given consent for additional secondary procedures, if they prove necessary.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D011884 Radius The outer shorter of the two bones of the FOREARM, lying parallel to the ULNA and partially revolving around it. Radial Tuberosity,Radial Tuberosities,Tuberosities, Radial,Tuberosity, Radial
D001859 Bone Neoplasms Tumors or cancer located in bone tissue or specific BONES. Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D005260 Female Females
D005360 Fibula The bone of the lower leg lateral to and smaller than the tibia. In proportion to its length, it is the most slender of the long bones. Fibulas
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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