TechniquesVascularized Ulnar Transposition and Radioulnoscapholunate Fusion With Volar Locking Plate in a Dorsal Position Following Resection of Giant Cell Tumor of the Distal RadiusVan Handel, Amelia C. MD*; Galvez, Michael G. MD†; Brogan, David M. MD‡; Boyer, Martin I. MD‡; Cipriano, Cara A. MD‡; Hirbe, Angela C. MD, PhD§; Pet, Mitchell A. MD*Author Information *Division of Plastic Surgery ‡Department of Orthopedic Surgery §Division of Oncology, Washington University in St. Louis, St. Louis, MO †Division of Plastic Surgery, Valley Children’s Hospital, Madera, CA Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Amelia C. Van Handel, MD, Division of Plastic Surgery, Washington University in St. Louis, St. Louis 63110, MO. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: September 2020 - Volume 24 - Issue 3 - p 142-150 doi: 10.1097/BTH.0000000000000282 Buy Metrics Abstract Giant cell tumor of the distal radius is a rare, locally destructive, and frequently recurrent tumor. We present a case of Campanacci Grade III giant cell tumor of the distal radius with pathologic fracture and cortical destruction which was treated with neoadjuvant denosumab. This facilitated en-bloc resection of the entire distal radius, including the articular surface, while minimizing tumor contamination. Reconstruction was accomplished using a vascularized ulnar transposition flap to facilitate radioulnoscapholunate fusion, which was fixated using a long-stem contralateral variable angle locking volar distal radius plate in a dorsal position. This case illustrates multidisciplinary management of a challenging reconstructive problem and demonstrates a novel strategy for fixation which repurposes familiar and readily available hardware to provide optimal osteosynthesis. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.