Fracture Prosthesis in Giant Cell Tumor of Distal Radius: Precautions and Management

Original Article | Volume 6 | Issue 2 | JBST May-August 2020 | Page 5-8 | Mahesh Kulkarni, Sourab Shetty, Monappa Naik, Sandeep Vijayan. DOI: 10.13107/jbst.2020.v06i02.23

Author: Mahesh Kulkarni[1], Sourab Shetty[1], Monappa Naik[1], Sandeep Vijayan[1]

[1]Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.

Address of Correspondence
Dr. Sourab Shetty,
Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal – 576 104, Udupi, Karnataka, India.


Introduction: Distal radius is one of the common locations for giant cell tumor (GCT) in the second to the fourth decade of life. Based on the extent of the tumor, various treatment options are available such as curettage and bone grafting or use of bone cement, various ablation techniques, excision, and vascularized or non-vascularized fibular graft. However, when subchondral bone and articular surface are involved and the patient is not ready for the fibular grafting, one of the methods described is excision and use of custom-made acrylic prosthesis, of which fracture prosthesis is a complication. Here, we are reporting a case who presented with a fractured prosthesis,  the way we managed it and the precautions that can be taken while use of the prosthesis.
Case Report: We are presenting a case of a 42-year-old male who came back after 2 years of implantation with a fractured prosthesis, which happened during a routine activity. There was no evidence of recurrence of the tumor. A discussion about the cause, the management done, precautions to be taken while implanting acrylic prosthesis, and a follow-up of the patient for 3 years is also done.
Conclusion: Acrylic can be used as a cost-efficient material for a prosthesis in both primary excision and revisions in distal radius GCT with good functional results if specific precautions are taken preoperatively and intraoperatively.
Keywords: Acrylic prosthesis, broken prosthesis, fractured prosthesis, radius giant cell tumor.

1. Renard AJ, Veth RP, Pruszczynski M, Wobbes T, Lemmens JA, van Horn JR. Giant cell tumor of bone: Oncologic and functional results. J Surg Oncol 1994;57:243-51.
2. Ekardt JJ, Grogan TJ. Giant cell tumor of bone. Clin Orthop Relat Res 1986;204:43-48.
3. Jaffe HL, Lichtenstein L, Portis RB. Giant cell tumor of the bone: Its pathological appearance, grading, supposed variant and treatment. Arch Pathol 1940;30:993-1031.
4. Klenke FM, Wenger DE, Inwards CY, Rose PS, Sim FH. Giant cell tumor of bone: Risk factors for recurrence. Clin Orthop Relat Res 2011;469:591-9.
5. O’Donnell RJ, Springfield DS, Motwani HK, Ready JE, Gebhardt MC, Mankin HJ. Recurrence of giant-cell tumors of the long bones after curettage and packing with cement. J Bone Joint Surg Am 1994;76:1827-33.
6. Campanacci M, Baldini N, Boriani S, Sudanese A. Giant-cell tumor of bone. J Bone Joint Surg Am 1987;69:106-14.
7. Sanerkin NG. Malignancy, aggressiveness, and recurrence in giant cell tumor of bone. Cancer 1980;46:1641-9.
8. Trieb K, Bitzan P, Lang S, Dominkus M, Kotz R. Recurrence of curetted and bone-grafted giant-cell tumours with and without adjuvant phenol therapy. Eur J Surg Oncol 2001;27:200-2.
9. Briggs TW, Cobb J, McAuliVe T, Pringle J, Kemp H. Giant cell tumours of bone. J Bone Joint Surg 1990;72B:937.
10. Griend RA, Funderburk CH. The treatment of giant-cell tumors of the distal part of the radius. J Bone Joint Surg Am 1993;75A:899-908.
11. Gold AM. Use of a prosthesis for the distal portion of the radius following resection of a recurrent giant-cell tumor. J Bone Joint Surg 1957;39A:1374.
12. Blake SM, Gie GA. Large pelvic giant cell tumor: A Case report and a review of current treatment modalities. J Arthroplasty 2004;19:1050-4.
13. Errani C, Ruggieri P, Asenzio MA, Toscano A, Colangeli S, Rimondi E, et al. Giant cell tumor of the extremity: A review of 349 Cases from a single institution. Cancer Treat Rev 2010;36:1-7.
14. McGough RL, Rutledge J, Lewis VO, Lin PP, Yasko AW. Impact severity of local recurrence in giant cell tumor of bone. Clin Orthop Relat Res 2005;438:116-22.
15. Saraf S, Goel S. Complications of resection and reconstruction in giant cell tumour of distal end of radius-an analysis. Indian J Orthop 2005;39:206.
16. Chadha M, Arora SS, Singh AP, Gulati D, Singh AP. Autogenous non-vascularized fibula for treatment of giant cell tumor of distal end radius. Arch Orthop Trauma Surg 2010;130:1467-73.
17. Boons HW, Keijser LC, Schreuder BH, Pruszczynski M, Lemmens JA, Veth RP. Oncologic and functional results after treatment of giant cell tumors of bone. Arch Orthop Trauma Surg 2002;122:17-23.
18. Beyli MS, von Fraunhofer JA. An analysis of causes of fracture of acrylic resin dentures. J Prosthet Dent 1981;46:238-41.
19. Beyli MS, von Fraunhofer JA. Repair of fractured acrylic resin. J Prosthet Dent 1980;44:497-503.
20. Vallittu PK, Lassila VP. Effect of metal strengthener’s surface roughness on fracture resistance of acrylic denture base material. J Oral Rehabil 1992;19:385-91.

How to Cite this article: Kulkarni M, Shetty S, Naik M, Vijayan S | Fracture Prosthesis in Giant Cell Tumor of Distal Radius: Precautions and Management | Journal of Bone and Soft Tissue Tumors | May-August 2020; 6(2): 5-8.

[Full Text HTML] [Full Text PDF] [XML]