# Management of Recurrent Giant Cell Tumor of Distal Tibia With Intramedullary Hindfoot Fusion Nail and Trabecular Metal Implant Construct

## TL;DR

A 36-year-old woman with a recurring giant cell tumor in her distal tibia was successfully treated using a combination of surgical resection and a specialized nail and metal implant.

## Contribution

A novel surgical approach combining a hindfoot nail and trabecular metal cone for treating recurrent giant cell tumors in the distal tibia is presented.

## Key findings

- The patient recovered well post-surgery with successful joint fusion.
- The treatment method proved effective for large, recurrent GCT lesions in the distal tibia.
- The combination of intramedullary nail and trabecular metal cone provided structural stability.

## Abstract

Reconstruction options for giant cell tumors (GCTs) of bone are limited and challenging due to the amount of structural compromise and the high recurrence rates. This is especially true for GCTs of the foot and ankle, as the area is vital for weight bearing and function. The typical treatment for GCTs is currently excision, curettage, and cementation, although that is not always effective. A 36-year-old otherwise healthy female presented with an original diagnosis of a large aneurysmal bone cyst (ABC) of the distal tibia that had recurred despite two previous attempts at treatment with resection and cementation. She was treated with surgical resection of the lesion, reconstruction, and ankle and subtalar joint arthrodesis with a tibiotalocalcaneal intramedullary nail in combination with a trabecular metal cone. The final pathology of the intraoperative samples was consistent with GCT. Postoperatively, she recovered well, and her imaging was consistent with a successful fusion. This case report provides evidence that tibiotalocalcaneal fusion with a unique combination of hindfoot nail and trabecular metal cone construct in a single procedure is a successful option for the treatment of large, recurrent GCT lesions in the distal tibia.