Augmentation of Osteoarticular Allograft Reconstruction With Photodynamic Nail for the Management of Primary or Recurrent Aggressive Giant Cell Tumor in the Distal Radius

The distal radius is one of the most common locations for giant cell tumors, which are benign, locally destructive osteolytic lesions that have a propensity for recurrence. As a result, treatment for giant cell tumors almost always requires surgical intervention with aggressive lesions requiring en bloc resection and reconstruction of the wrist either with radiocarpal arthrodesis or osteoarticular allograft reconstruction (OAR). Although there is currently no gold standard reconstructive procedure, OAR has emerged as a promising reconstructive technique because of its preservation of wrist mobility, accuracy of size-matching, lack of donor-site morbidity, and comparatively short surgical time. Nevertheless, a major issue with OAR is its relatively high complication rate, largely pertaining to nonunion and fracture, given that it takes a prolonged period of time for the allograft to undergo consolidation with the remaining native patient bone. To mitigate the incidence of fracture-related complications, we propose a novel surgical technique that augments the OAR with the use of an intramedullary photodynamic implant in conjunction with locking compression plates and a concomitant Suave-Kapandji procedure.