Vascularized Proximal Fibula Transfer to Distal Radius: Reconstruction of Large Bone Defects Including DRUJ Stabilization After Giant Cell Tumor Excision

In this article, a new modification technique is described to reconstruct large bone defects of the distal radius after en bloc giant cell tumor resection with a proximal vascularized fibula graft. We discuss anatomic landmarks during graft harvest as well as reconstructive considerations. We aim for a durable reconstruction with optimal mobility and, therefore, introduce a fibular-scaphoid-lunate fusion with a reconstruction of the distal fibula-ulnar joint with an "Adams-Berger-like" procedure with a palmaris longus tendon. The clinical results of 3 patients who underwent this procedure were included in this study and showed promising results in terms of wrist mobility, union, and overall patient satisfaction during follow-up.