Functional Outcome in Non-Vascularized Fibular Grafting Following Distal Radius Giant Cell Tumor Resection in RSUD Dr. Saiful Anwar Malang: A Case Series and Literature Review

Introduction: Giant cell tumor (GCT) is an aggressive neoplasm that accounts for 3 to 5% of all bone neoplasms globally and is 20% higher in Asian countries. The distal radius is one of the most commonly involved sites. A non-vascularized fibular graft following wide resection is the most widely practiced reconstruction procedure. Nevertheless, functional outcome and donor site complications remain a potential barrier to the procedure. Objective: Evaluate the functional outcome and possible complications of the patients undergoing non-vascularized fibular grafting following wide resection of the distal radius GCT. Patients & Methods: From 2021 to 2023, 3 patients with GCT of distal radius were treated with wide resection followed by non-vascularized fibular grafting. An orthopedic oncologist and an orthopedic hand & microsurgery surgeon performed the procedure. The Disabilities of the Arm, Shoulder, and Hand (DASH) score was obtained pre- and post-operatively approximately 1 year after surgery. Any possible donor site complications, such as peroneal nerve injury as well as knee and ankle instability, were also evaluated post-operatively. Outcomes: Our patients' characteristics are middle-aged individuals (27 ± 4 years old) with slight female predominance. Pre- and post-operative DASH scores were 62 ± 16 and 10 ± 4, respectively (P 0.026). No significant donor site complication was encountered post-operatively.  Conclusion: The procedure of wide resection followed by non-vascularized fibular grafting in treating GCT of the distal radius due to fashionable functional outcomes was recommended with minimal complication risk.