광범위한 절제술 후 근위 비골 이식을 이용한 원위 요골 거대세포종의 치료

Treatment of Giant Cell Tumor of Distal Radius with Wide Resection and Proximal Fibular Graft

  • 김부환 (부산대동병원 정형외과) ;
  • 이상훈 (부산대동병원 정형외과) ;
  • 허무중 (부산대동병원 정형외과) ;
  • 천상진 (부산대학교 의과대학 정형외과학교실) ;
  • 류총일 (부산대학교 의과대학 정형외과학교실) ;
  • 김용진 (부산춘해병원 정형외과)
  • Kim, Bu-Hwan (Department of Orthopedic Surgery, Pusan Daedong Hospital) ;
  • Yi, Sang-Hun (Department of Orthopedic Surgery, Pusan Daedong Hospital) ;
  • Heo, Mu-Jung (Department of Orthopedic Surgery, Pusan Daedong Hospital) ;
  • Chun, Sang-Jin (Department of Orthopaedic Surgery, College of Medicine, Pusan National University) ;
  • Ryu, Chong-Il (Department of Orthopaedic Surgery, College of Medicine, Pusan National University) ;
  • Kim, Yong-Jin (Department of Orthopaedic Surgery, Pusan Choonhae Hospital)
  • 발행 : 2002.05.31

초록

Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.

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