Extended Reconstruction of the Right Forearm as Treatment for a Giant Cell Tumor With the Combined Use of a Free Fibular Flap and a Pedicled Inguinal Flap

Giant cell tumor of bone (GCTB) is a benign neoplasm with aggressive behavior, predominantly affecting young adults. In the majority of these lesions, curettage is the treatment of choice; however, those classified as Campanacci grade III typically require extensive surgical resection, resulting in significant bone and soft tissue defects. This represents a significant reconstructive challenge but offers the opportunity for limb preservation and functional maintenance instead of amputation. We present a 39-year-old male with a grade III GCTB of the distal radius, who had extensive tumor resection followed by a staged reconstructive approach in four distinct surgical phases. These involved excision of the lesion, reconstruction with a free fibular flap, and skin coverage using a pedicled inguinal flap. The postoperative course was uneventful, with no evidence of recurrence at three months. Functional recovery was favorable, with a wrist range of motion of 40° flexion and 30° extension. No postoperative complications were observed. The combined use of a free fibular flap and a pedicled inguinal flap proved to be an effective reconstructive strategy for managing complex upper extremity circumferential defects.