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DOI: 10.1055/s-0030-1249608
© Georg Thieme Verlag KG Stuttgart · New York
Rekonstruktion des distalen Radius mittels freiem mikrovaskulären Fibulatransplantat: 5-Jahres-Resultat nach en-bloc-Resektion eines Riesenzelltumors
Free Microvascular Fibula Graft for Skeletal Reconstruction of the Distal Radius: 5 Years Follow-up after en-bloc Resection of a Giant Cell TumourPublikationsverlauf
eingereicht 29.7.2009
akzeptiert 12.2.2010
Publikationsdatum:
05. Mai 2010 (online)

Zusammenfassung
Die histologisch gesicherte Diagnose eines Riesenzelltumors der Hand oder des Handgelenkes sollte wie ein niedriggradig malignes Tumorleiden behandelt werden. Eine tendenziell höhere Aggressivität, die Metastasierungs- und Lokalrezidivrate sowie die topografische Nähe zu den Leitungsbahnen machen ein sehr differenziertes chirurgisches Vorgehen erforderlich. Anhand des Falles einer 54-jährigen Patientin mit Riesenzelltumor der körperfernen Speiche des Stadiums III nach Campanacci werden die Behandlungsmöglichkeiten und Prinzipien des Riesenzelltumors dargestellt.
Abstract
A giant cell tumour of the distal radius or of the carpal bones, verified by incisional biopsies, should be approached as a low-grade malignancy. Lesions that arise in the bones of the hand or the wrist have a greater propensity to metastasise, and have a higher risk of local recurrence. In this case report we describe a 54-year-old women with a giant cell tumour of the distal radius (Campanacci grade III lesion), having a follow-up of five years without signs of local recurrence or metastatic disease. The general principles of and options for surgical treatment are discussed.
Schlüsselwörter
Tumor - Knochen - Riesenzelltumor - freies mikrovaskuläres Fibulatransplantat
Key words
tumour - bone - giant cell tumour - free microvascular fibula graft
Literatur
- 1
Campanacci M, Baldini N, Boriani S. et al .
Giant-cell tumor of bone.
J Bone Joint Surg [Am].
1987;
69
106-114
MissingFormLabel
- 2
Lackman RD, McDonald DJ, Beckenbaugh RD. et al .
Fibular reconstruction for giant cell tumor of the distal radius.
Clin Orthop Relat Res.
1987;
218
232-238
MissingFormLabel
- 3
Murray JA, Schlafly B.
Giant-cell tumors in the distal end of the radius. Treatment by resection and fibular
autograft interpositional arthrodesis.
J Bone Joint Surg [Am].
1986;
68
687-694
MissingFormLabel
- 4
Bickert B, Heitmann C, Germann G.
Fibulo-scapho-lunate arthrodesis as a motion-preserving procedure after tumour resection
of the distal radius.
J Hand Surg [Br].
2002;
27
573-576
MissingFormLabel
- 5
Jacobs PA, Clemency Jr. RE.
The closed cryosurgical treatment of giant cell tumor.
Clin Orthop Relat Res.
1985;
192
149-158
MissingFormLabel
- 6
Minami A, Kato H, Iwasaki N.
Vascularized fibular graft after excision of giant-cell tumor of the distal radius:
wrist arthroplasty versus partial wrist arthrodesis.
Plast Reconstr Surg.
2002;
110
112-117
MissingFormLabel
- 7
Athanasian EA, Wold LE, Amadio PC.
Giant cell tumors of the bones of the hand.
J Hand Surg [Am].
1997;
22
91-98
MissingFormLabel
- 8
O’Donnell RJ, Springfield DS, Motwani HK. et al .
Recurrence of giant-cell tumors of the long bones after curettage and packing with
cement.
J Bone Joint Surg [Am].
1994;
76
1827-1833
MissingFormLabel
- 9
Vander Griend RA, Funderburk CH.
The treatment of giant-cell tumors of the distal part of the radius.
J Bone Joint Surg [Am].
1993;
75
899-908
MissingFormLabel
- 10
Bertoni F, Present D, Sudanese A. et al .
Giant-cell tumor of bone with pulmonary metastases. Six case reports and a review
of the literature.
Clin Orthop Relat Res.
1988;
237
275-285
MissingFormLabel
- 11
Dahlin DC, Cupps RE, Johnson Jr EW.
Giant-cell tumor: a study of 195 cases.
Cancer.
1970;
25
1061-1070
MissingFormLabel
- 12
Harness NG, Mankin HJ.
Giant-cell tumor of the distal forearm.
J Hand Surg [Am].
2004;
29
188-193
MissingFormLabel
- 13
Giessler GA, Bickert B, Sauerbier M. et al .
Das freie mikrovaskuläre Fibulatransplantat zur Skelettrekonstruktion nach Tumorresektion
am Unterarm - Erfahrungen aus fünf Fällen.
Handchir Mikrochir Plast Chir.
2004;
36
301-307
MissingFormLabel
- 14
Leung PC, Chan KT.
Giant cell tumor of the distal end of the radius treated by the resection and free
vascularized iliac crest graft.
Clin Orthop Relat Res.
1986;
202
232-236
MissingFormLabel
Korrespondenzadresse
Dr. Torsten Franz
Klinik für Plastische und
Hanchirurgie
Inselspital Bern
3010 Bern
Schweiz
eMail: torsten.franz@insel.ch