Clinical Study Of Autogenous Fibula Bone Transfer And Reconstruction Of Joint Prosthesis In The Treatment Of Radius GCT

ObjectiveRetrospective analysis of autologous fibula bone graft reconstruction and joint prosthesis reconstruction after complete resection of giant cell tumor of the distal radius to evaluate the recovery of postoperative wrist function and common surgical complications,providing a theoretical basis for clinical application.MethodsThe Department of Orthopaedics,Henan Cancer Hospital,20014.1-2017.12,was selected.(23)Cases of distal radius giant cell tumor Campanacci grade II-III,with complete follow-up data.According to the different surgical methods,the patients were divided into two groups.Among them,13 patients in group A were treated with tumor segmental resection and autologous fibula bone graft to reconstruct bone defect and restore the integrity of wrist joint.10 patients in group B were treated with tumor segmental bone prosthesis reconstruction wrist.joint.Data were analyzed for the surgical methods,time and bleeding volume,postoperative bone healing,wrist function,local recurrence rate and common complications of the two groups.The bleeding volume and postoperative wrist function of the two groups were analyzed.The composition of measurement data such as Mayo scores was statistically used.Results1.The operation time was 170.62±23.43 min in group A,143.22±14.34 min in group B,346.15±32.67 ml in group A,and 220.56±27.09 ml in group B.The operation time and intraoperative blood loss in group A were higher than those in group B.The difference was statistically significant(p < 0.05).2,13 patients in the A group(autologous fibula bone graft group)were followed up for 12-52 months,with an average of 31.69 months.Wrist activity: preoperative: palm flexion: 33.69±4.29°,dorsiflexion: 27.23±4.42°,radial deviation: 12.31±2.53°,ulnar deviation: 20.46±3.20°.The Mayo score of the affected wrist was(44.27±8.13)points.Postoperative: palm flexion: 36.38±4.31°,dorsiflexion: 31.15±4.06°,radial deviation: 15.54±2.57°,ulnar deviation: 22.15±2.88°.The Mayo score of the affected wrist was(66.84±7.23)points.Preoperative and postoperative wrist mobility comparison and Mayo score were statistically significant(p<0.05).The main complications were: 1 case of postoperative internal fixation and infection;2 cases of postoperative lower ankle joint dislocation;1 case of postoperative 1 year follow-up found pulmonary metastasis,no local recurrence.3,Group B(artificial wrist joint prosthesis replacement group)10 patients were followed up for 15-50 months,an average of 30.33 months.Wrist activity: preoperative: palm flexion: 32.67 ± 3.61 °,dorsiflexion: 25.78 ± 5.36 °,radial deviation: 11.89 ± 1.76 °,ulnar deviation: 19.22 ± 2.22 °.The Mayo score of the affected wrist was(48.35±9.62)points.Postoperative: palm flexion: 41.30±4.67°,dorsiflexion: 39.90±4.48°,radial deviation: 14.44±1.59°,ulnar deviation: 24.90±1.66°.The Mayo score of the affected wrist was(76.00 ± 6.42)points.Preoperative and postoperative wrist mobility comparison and Mayo score were statistically significant(p<0.05).Main complications: 1 patient had a superficial infection of the incision,and 1 patient had a dislocation of the ankle and ankle joint at 1 year follow-up,with no local recurrence.4.Analysis of wrist mobility in the two groups after operation,except for sputum deviation(P=0.27),the improvement of palmar flexion,dorsal extension and ulnar deviation function was better in group B than in group A.The final follow-up Mayo score,A Group:(68.56±12.72)points,group B:(74.51±10.19)points,the two Mayo scores improved significantly,the difference between the groups was statistically significant(P<0.05).Conclusions1、Autologous fibula bone transplantation reconstruction and joint prosthesis reconstruction,postoperative wrist function recovery was significantly improved compared with preoperative,statistically significant,no local recurrence occurred in the two groups of patients.There was no significant diversity in the effect of local recurrence control with the two surgical pairs.2、Wrist joint prosthesis replacement is simple,surgical trauma,operation time,bleeding volume and postoperative complications are less than that of fibula bone graft reconstruction.The final follow-up results of wrist and joint function in addition to sputum,joint prosthesis replacement The short-term effect of wrist joint function recovery is better than autologous fibula bone graft.