Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2017; 8(9): 741-746
Published online Sep 18, 2017. doi: 10.5312/wjo.v8.i9.741
Hernia mesh prevent dislocation after wide excision and reconstruction of giant cell tumor distal radius
I Gede E Wiratnaya, I Gusti Bagus Arie M Budiartha, I Gusti Ngurah Y Setiawan, Dwijo A Sindhughosa, I Ketut S Kawiyana, Putu Astawa
I Gede E Wiratnaya, I Gusti Bagus Arie M Budiartha, I Gusti Ngurah Y Setiawan, I Ketut S Kawiyana, Putu Astawa, Department of Orthopedic and Traumatologic, Faculty of Medicine, Udayana University Sanglah General Hospital, Denpasar, Bali 80113, Indonesia
Dwijo A Sindhughosa, Faculty of Medicine, Udayana University Sanglah General Hospital, Denpasar, Bali 80113, Indonesia
Author contributions: Wiratnaya IGE, Budiartha IGBAM, Setiawan IGNY and Sindhughosa DA designed the report; Wiratnaya IGE and Budiartha IGBAM perform the surgery; Budiartha IGBAM, Setiawan IGNY, Kawiyana IKS and Astawa P collected the patient’s clinical data; Wiratnaya IGE and Sindhughosa DA wrote the paper.
Institutional review board statement: This case report was approved by the ethics committee of Sanglah General Hospital (Bali, Indonesia).
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest regarding this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. I Gede E Wiratnaya, SpOT, Department of Orthopedic and Traumatologic, Faculty of Medicine, Udayana University Sanglah General Hospital, Diponegoro Street, Dauh puri Klod, Denpasar, Bali 80113, Indonesia. ekawiratnaya@unud.ac.id
Telephone: +62-8133-8493832 Fax: +62-0361-224206
Received: January 23, 2017
Peer-review started: January 29, 2017
First decision: May 11, 2017
Revised: May 18, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: September 18, 2017
Abstract

Giant cell tumor (GCT) remains as major health problem. GCT which located at the lower end of the radius tends to be more aggressive. Wide excision and reconstruction of the wrist in stage 3 of distal radius GCT lesion is an optimal modality to prevent tumor recurrence. However, dislocation often occurs as its complication. We are reporting patient with GCT of distal radius treated with wide excision and reconstruction using nonvascularized fibular graft and the addition of hernia mesh. Circumferential non-absorbable polypropylene hernia mesh was applied, covered radioulnar joint and volar aspect of radius, and served as additional support to prevent dislocation. During five years and two months of follow-up, we found no dislocation in our patient. Furthermore, good functional outcome was obtained. Our finding suggests that the addition of hernia mesh after wide excision and reconstruction with nonvascularized fibular graft may benefit to prevent dislocation and provides an excellent functional outcome.

Keywords: Giant cell tumor, Wide excision, Fibular graft, Hernia mesh, Dislocation

Core tip: Dislocation after wide excision and reconstruction with nonvascularized fibular graft on giant cell tumor (GCT) distal radius often occur and becomes a problem for the patient. This case report presented the outcome of a patient with GCT of distal radius and treated with wide excision and nonvascularized fibular graft with the addition of non-absorbable polypropylene hernia mesh. Circumferential non-absorbable polypropylene hernia mesh may prevent the occurrence of dislocation and provides an excellent functional outcome.