Functional outcome of free fibula grafting in benign non-reconstructable bone tumours involving the hand

Abstract

Background: Bone tumours involving hands are usually benign but can be locally aggressive. Several treatments have been described. Usual modalities of treatment include curettage and bone grafting. In more advanced stages when short bones of the hand are involved with more than 70% cortical destruction, or when such treatment option is not possible (as with non-contained tumours with cortical breaches, pathological fracture), only the resection or amputation of the affected segment can offer an effective cure. We studied the role of the free fibula graft (nonvascularised) in such types of benign non-reconstructable (by conventional methods) hand tumours. The aims and objectives were to study the functional outcome of free fibula grafting in benign non-reconstructable bone tumours involving the hand and to analyse the complications, if any, and assess the causes and solutions for them.

Methods: We prospectively studied 15 patients with different types of benign, non-reconstructable bone tumours involving the hand operated by free fibula grafting. The study period ranged from January 2014 to December 2021. Follow-up ranged from 2 to 8 years (average of 4.26 years).

Results: Results were analysed by the QuidkDASH-9 score system. There was no recurrence. One case of superficial infection was treated with antibiotics and dressing. All patients were happy with the treatment and resumed their normal duties and functional movements.

Conclusion: Use of the free fibula graft can be a good option for benign non-reconstructable bone tumours involving the hand to avoid amputation. The free fibula graft gives better results due to total excision of the lesion and strut graft support for good functional outcomes.

Level of evidence: Level 3