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NATURAL EVOLUTION OF UNGRAFTED BONE DEFECTS FOLLOWING CURRETAGE OF TUMOURS OF DISTAL RADIUS



Abstract

We report the results of contained bone defects after curettage of benign bone tumours of the distal radius treated without bone grafting or the use of bone substitute. 11 consecutive patients treated with follow-up of 3 to 11 years (mean 5.7 years) were studied. The mean age at diagnosis was 27 (range 11 to 55). There were7 males and 4 females. Histological diagnosis was giant cell tumour in 8 and aneurismal bone cyst in 3 patients. The mean bone defect at diagnosis was 23.7cm3 (9.2 – 68cm3). Pathological fracture was present in 5 patients prior to surgery. We observed full radiological consolidation of the defects in all the patients within 12 months of surgery. Radiologically detectable osteoarthritis was noted in 5 patients (grade 1 in two patients, grade 2 in one and grade 4 in two patients). Development of osteoarthritis was significantly related to size of the defect and involvement of the joint by the original tumour. No patient without joint involvement developed osteoarthritis. There was no relationship between pathological fracture and development of osteoarthritis.

We conclude that contained bone defects in the distal radius do rapidly consolidate without the use of bone grafting or bone substitute. The bone remodels nicely over time. Development of osteoarthritis is related to the damage to the articular defect caused by the tumour.

The abstracts were prepared by Mrs Leslie O’Leary. Correspondence should be addressed to her at British Orthopaedic Association, 35–43 Lincoln’s Inn Fields, London WC2A 3PE or at l.oleary@boa.ac.uk