Custom-made wrist prosthesis in a patient with giant cell tumor of the distal radius

• Published in: Archives of orthopaedic and trauma surgery 2013-05, Vol.133 (5), p.713-719
• Main Authors: Damert, Hans-Georg, Altmann, Silke, Kraus, Armin
• Format: Article
• Language: English
• Subjects: Adult; Arthroplasty, Replacement; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - surgery; Giant Cell Tumor of Bone - diagnostic imaging; Giant Cell Tumor of Bone - surgery; Handsurgery; Humans; Imaging, Three-Dimensional; Joint Prosthesis; Male; Medicine; Medicine & Public Health; Orthopedics; Prostheses; Radius; Surgery; Tomography, X-Ray Computed; Wrist Joint - diagnostic imaging; Wrist Joint - surgery
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-013-1692-y

Introduction Treatment for giant cell tumors of the distal radius is challenging when motion is to be preserved. As standard wrist prostheses typically do not achieve favorable results, we treated a 36-year-old man with giant cell tumor of the distal radius with a new, custom-made implant. Methods A custom-made wrist prosthesis with a long shaft was designed according to the patient’s X-ray findings. After complete tumor resection, the prosthesis was subsequently implanted into the distal radius without complications. Results Two months after surgery, range of motion was 30°-0-25° for extension/flexion, 10°-0-5° for ulnar/radial abduction, 80°-0-0 for pronation/supination, complete range of motion for the fingers, and a grip strength of 6 kg. Two years after surgery, implant position was still correct and range of motion was 45°-0-10° for extension/flexion, 10°-0-20° for ulnar/radial abduction, and 80°-0-10° for pronation/supination. Grip strength was 16 kg, and DASH score was 25 compared to 39 before surgery. The patient returned to work as a craftsman. Conclusion Custom-made wrist prostheses could become a practical option in patients with large defects of the distal radius who desire to preserve wrist motion.