Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2025; 92(1):52-57 | DOI: 10.55095/achot2024/068

Combined Proximal Radius Reconstruction Following Resection for Oncological IndicationCase report

MÁRIO MALINA¹, MATEJ MAJERČÍK¹, YOUSEF NASER²

¹ I. ortopedicko-traumatologická klinika Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice Bratislava

² Klinika ortopédie a traumatológie pohybového ústrojenstva Univerzitnej nemocnice L. Pasteura Košice

Early surgical treatment of giant cell tumour of the bone has very good functional outcomes with a relatively low risk of local recurrence and metastatic spread.
In case of a pathologic fracture, extraosseous extension, and tumor location in an anatomically difficult area, surgical treatment may represent a big challenge with an uncertain functional outcome.
Our case report presents a 35-year-old  patient with a delayed diagnosis of giant cell tumor of the proximal radius of the dominant limb, with pulmonary metastases. Following neoadjuvant Denosumab therapy, with a major treatment effect on both the primary tumor and pulmonary metastases, we performed a wide resection and combined biological reconstruction with fibular autograft, radial head endoprosthesis, and comprehensive elbow ligament reconstruction.
At 24 months after surgery, the patient is self-sufficient, capable of more physically demanding work, with a satisfactory functional outcome of reconstruction (MSTS 66.6%, TESS 69%), with no signs of local recurrence and regression of pulmonary metastases at 18 months after the last administration of Denosumab.

Keywords: giant cell tumor of the bone, wide resection, proximal radius, Denosumab, biological reconstruction.

Received: March 31, 2024; Revised: March 31, 2024; Accepted: November 7, 2024; Published: March 13, 2025  Show citation