Functional Outcome of En Bloc Excision and Osteoarticular Allograft Replacement With the Sauve-Kapandji Procedure for Campanacci Grade 3 Giant-Cell Tumor of the Distal Radius

Robert M Szabo, Kurt A. Anderson, James L. Chen

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Purpose: Multiple options have been reported for reconstruction of Campanacci grade 3 giant-cell tumor of the distal radius after resection. In 1990, the senior author described an allograft reconstruction combined with a Sauve-Kapandji procedure after distal radius resection and reported preliminary results in 3 patients. The purpose of this study was to assess with validated patient outcome surveys the intermediate to long-term outcomes of all patients treated with this surgery and to analyze their functional results and document tumor control. Methods: All cases of distal radius osteoarticular allograft combined with the Sauve-Kapandji reconstruction for Campanacci grade 3 giant-cell tumors performed from 1986 to 2000 by a single surgeon were evaluated by clinical and radiologic examinations; the Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form-36; and Mayo Wrist scores. Results: Nine consecutive patients (7 women, 2 men) with an average age at follow-up evaluation of 42 years and with a Campanacci grade 3 giant-cell tumor of the distal radius formed the study population. Clinical follow-up time after reconstruction averaged 7 years. Examination showed an average of 51° of extension and 19° of flexion of the wrist and 63° of supination and 79° of pronation of the forearm. Grip strength measured in 5 patients averaged 23 kg. The Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form-36; and the Mayo Wrist scores averaged 15, 72, and 73, respectively. These scores indicate modest functional impact. No patient had tumor recurrence, metastases, nonunion, or proximal ulna instability. Conclusions: En bloc resection of a Campanacci grade 3 giant-cell tumor of the distal radius followed by reconstruction with an osteoarticular allograft and a Sauve-Kapandji procedure with autogenous bone graft results in a reasonable functional outcome at intermediate to long-term follow-up evaluation. Type of study/level of evidence: Therapeutic IV.

Original languageEnglish (US)
Pages (from-to)1340-1348
Number of pages9
JournalJournal of Hand Surgery
Volume31
Issue number8
DOIs
StatePublished - Oct 2006

Keywords

  • allograft
  • distal radius
  • Giant-cell tumor
  • Suave-Kapandji
  • wrist

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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