# 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

## TL;DR

A 39-year-old man with a severe bone tumor in his forearm underwent successful surgery using two specialized tissue flaps, preserving his limb and function without recurrence.

## Contribution

The paper presents a novel reconstructive approach using combined free fibular and pedicled inguinal flaps for complex upper extremity defects after tumor resection.

## Key findings

- The combined flap technique successfully reconstructed a complex forearm defect after tumor removal.
- The patient showed favorable functional recovery with wrist motion and no postoperative complications.
- There was no evidence of tumor recurrence at three months post-surgery.

## Abstract

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.