Abstract :
Giant cell tumour of bone (GCT-B) is a locally aggressive tumour with a significant risk of recurrence. Management of juxtaarticular GCTs is particularly challenging due to the need to preserve joint function while reducing recurrence rates. This study aims to evaluate the functional and radiological outcomes of patients with juxtaarticular GCTs managed with extended curettage, with and without fixation, in a govt. tertiary care facility.
Three cases of GCT-B (distal radius, proximal humerus, and distal femur) were managed with extended curettage. Surgical techniques included wide excision of the tumour, curettage of the cavity with adjuvants (phenol, hydroxyapatite granules), and fixation in cases with pathological fractures. Functional outcomes were evaluated using range of motion (ROM), and radiological outcomes assessed bone healing and recurrence.
At 3 and 6 months post-operatively, all patients showed significant improvements in joint function with signs of bone healing and no signs of recurrence. Case 1 (distal radius) achieved wrist flexion of 55°and extension of 60°. Case 2 (proximal humerus) regained full ROM, and Case 3 (distal femur) showed active knee flexion of 50°and passive flexion of 100° with union of the fracture.
Extended curettage with adjuvants and appropriate fixation in cases of pathological fractures effectively preserves joint function and reduces recurrence risk. This approach is feasible even in resource-constrained settings, offering patients improved quality of life post-operatively.
Keyword :
Giant cell tumour, Curettage, Distal femur, proximal humerus, Distal radius, Pathological fracture, Sandwich technique.