Artikel
10-year-follow-up after implantation of a custom made wrist prosthesis in a patient with giant cell tumor oft he distal radius
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Autoren
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Hans-Georg Damert
- Plastic, Aesthetic and Handsurgery, Helios Bördeklinik, Oschersleben/Neindorf, Germany
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Melanie Kober
- Plastic, Aesthetic and Handsurgery, Helios Bördeklinik, Oschersleben/Neindorf, Germany
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: In contrast to implants of large joints, there is no standardized procedure for wrist implants in hand surgery, with the method being considerably newer. Over the years, the design of the implants has been changed due to the problems observed during their use. In case of total destruction of the wrist, complete arthrodesis usually is the method of choice. However, patients' desire to preserve at least residual motion is becoming more and more crucial. Although long-term results for current wrist implants are still missing, a wrist implant is an alternative option to arthrodesis in the opinion of the authors. The case presented describes the use of a tumor wrist prosthesis based on the "Universal2©" model (KMI) in a patient with tumor destruction of the distal radius by a giant cell tumor.
Methods: After resection of the tumor there was a defect of the distal radius over a length of more than 6,5 cm. The 36 year old patient urgently demanded to preserve function and refused free fibular graft and arthrodesis whenever possible. Due to the good results experienced with the Uni2 implant, the idea to design a tumor prosthesis based on this device was born. The tumor implant was manufactured according to the patient's x-ray images in cooperation with ArgoMedical Company. After cost approval by the patient's health insurance a custom made device could be manufactured and implanted. So we could do the implantation in April 2009. The patient has returned to work after 6 months.
At the international congress we will present the ten year follow-up of this case. At the moment there is still good function with extension/flexion 30-0-20, ulnar/radial abduction 10-0-5 and pronation/supination of 80-0-80. During this time the patient doesn't need a second surgery and there was no complication. The patient still works and has hobbys like fishing and motorbiking.
Results and Conclusions: In our opinion the tumor wrist prosthesis may be an alternative or an option compared to a free fibula transplantation for the treatment of larger defects. You don't have a donor side morbidity, the operation is not so complex and was doing in 2 ours with less collateral damage. This patient still has a good live quality and would take this treatment once again.
