case_images: PMC11723745_01
case_images: Swelling over the dorsolateral aspect of right wrist joint.
case_images: JOCR-15-41-g001.jpg
case_images: PMC11723745_01_JOCR-15-41-g001.jpg
case_images: F1
case_images: A 44-year-old male presented with complaints of right wrist pain and swelling (Fig. 1) for the past 3 months.
case_images: X-ray of right distal radius anteroposterior and lateral view.
case_images: JOCR-15-41-g002.jpg
case_images: PMC11723745_01_JOCR-15-41-g002.jpg
case_images: F2
case_images: X-ray of right wrist taken at the time of onset of symptoms - 3 months before presentation (Fig. 2) showed solitary, radiolucent, eccentric lesion over epiphysis and metaphyseal region of right distal radius with narrow zone of transition, with thin cortex.
case_images: X-ray wrist with forearm anteroposterior and lateral view shows radiolucent lesion over the metaphyseal region.
case_images: JOCR-15-41-g003.jpg
case_images: PMC11723745_01_JOCR-15-41-g003.jpg
case_images: F3
case_images: X-ray taken at the time of presentation (Fig. 3) showed the same findings but with additional break in the cortex over medial and lateral aspect of distal radius.
case_images: T1 and T2-weighted magnetic resonance imaging of right distal radius shows features suggestive of giant cell tumor.
case_images: JOCR-15-41-g004.jpg
case_images: PMC11723745_01_JOCR-15-41-g004.jpg
case_images: F4
case_images: Magnetic resonance imaging of right wrist joint (Fig. 4) shows diffuse aggressive expansile heterogenous lytic lesion with articular extension in the distal end of radius of length 3.8 cm involving the epiphyseal and meta-diaphyseal region with narrow zone of transition with cortical breach in the anterior and posterior aspect of lesion with extraosseous anterior and posterior projections.
case_images: Through dorsal approach over distal forearm and wrist tumor was resected with 3 cm clearance with surrounding soft tissue and wide local excision of giant cell tumor over distal radius with surrounding soft tissues was done.
case_images: JOCR-15-41-g005.jpg
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case_images: F5
case_images: Using bone holder, the tumor segment with segment of 3 cm of normal bone given for clearance was lifted up (Fig. 5).
case_images: Immediate post of X-ray of right distal radius with forearm anteroposterior (AP) and lateral showing plate fixation of proximal fibular graft with distal radius with transcarpal K-wire fixation. Post-operative X-ray of right leg AP and lateral showing graft site.
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case_images: F6
case_images: The fibular head was stabilized with two 2 mm Kirschner wires - one fixing it to the carpus and another to the distal ulna (Fig. 6).
case_images: Six-month follow-up X-ray of right forearm and wrist anteroposterior and lateral.
case_images: JOCR-15-41-g007.jpg
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case_images: F7
case_images: The patient was followed up at 3 months, 4 months, 6 months (Fig. 7), and 1 year (Fig. 8) and yearly once after, fibular graft was well united even at 6-month follow-up.
case_images: Range of movements of right wrist at 2-year and 8-month follow-up.
case_images: JOCR-15-41-g009.jpg
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case_images: F9
case_images: At 2 year and 8 months of follow-up, the patient had (Fig. 9) wrist palmar flexion of 30 , pronation of 70 , supination of 20 , dorsiflexion is NIL.
case_images: Post-operative X-ray of right distal radius anteroposterior and lateral at 2-year and 8-month follow-up shows well incorporated fibular graft with plate in situ.
case_images: JOCR-15-41-g010.jpg
case_images: PMC11723745_01_JOCR-15-41-g010.jpg
case_images: F10
case_images: X-ray showed that the fibular graft had well incorporated (Fig. 10).