Reconstruction of the distal radio-ulnar joint with a prosthesis of the distal ulna in the treatment of a recurrent giant cell tumour.

We present a case of 35-year old left-handed woman with recurrent giant-cell tumour affecting 1/4 of the distal part of the left ulna, with associated ulnar nerve involvement. After resection of the tumour and 1 cm of the ulnar nerve, the distal ulna was reconstructed with an individually designed and matched prosthesis, followed by ulnar nerve reconstruction. At 12 months follow-up the patients was free of pain, had excellent recovery of ulnar nerve function, satisfactory wrist range of motion and moderately impaired function of the left hand (DASH score 42). She returned to her original work in the office. We believe that restoration of the anatomy of the distal forearm after en block resection of the distal ulna is desirable in young, active patients, and that the prosthesis we used provides a good anatomical framework for the recovery of the function of the wrist.