Endoprosthetic Reconstruction of distal Humerus following Resection of distal Humeral Giant Cell Tumours in Six Patients in Rural India
- Author:
Balasubramanian N, MS, Gnanasundaram R, MS, Prakasam S, DGO
- Publication Type:Article
- Keywords:
giant cell tumour, endoprosthetic reconstruction, DASH scoring, custom mega prosthesis
- From:Malaysian Orthopaedic Journal
2017;11(2):25-29
- CountryMalaysia
- Language:English
-
Abstract:
Giant cell tumour is a commonly occurring benign bone
tumour in the Indian population. The common sites of
involvement in descending order of frequency are distal
femur, proximal tibia, distal radius and proximal humerus.
The less commonly occurring sites are distal humerus, pelvis
and proximal femur. We present six cases of giant cell
tumour involving the distal humerus in rural India. After
obtaining a tissue diagnosis by Trucut biopsy and classifying
using Enneking's classification, we proceeded to perform
wide resection followed by endoprosthetic reconstruction
using custom mega prosthesis. We present here six patients
(M: F: 2: 4) who were managed by us between 2008-2014.
They presented to us with pain around the elbow and
restriction in range of movements. They were each noted
radiographically to have a lytic lesion involving the distal
humerus with the likely diagnosis of giant cell tumour.
Closed biopsy was done in all of them to obtain a definitive
diagnosis. All patients underwent wide resection and
reconstruction using distal humerus custom prosthesis. All
patients were followed up at 6, 12, 18 and 24 weeks and
thereafter six monthly until the last review. They were
assessed using the DASH scoring system. All patients were
well with no evidence of recurrence with good to fair
functional outcome. We conclude that careful pre-operative
planning with meticulous soft tissue dissection and good
implant metallurgy and design, these tumours can be treated
with good long term functional results.
