NAVIGATING COMPLEXITY : SURGICAL MANAGEMENT OF GIANT CELL TUMOR OF FIBULA WITH CPN NERVE ENTANGLEMENT

Authors: AMOL KHAIRNAR, AKSHAY DESHMUKH, SAYAJI BHAMRE, ATUL PATIL, HARSHAL PATIL, Rakesh Sanivada, Rohit Dipwal

DOI: 10.18231/j.ijos.12444.1759129711

Keywords: GCT FIBULA PERONEAL NERVE METICULOUS DISSECTION,LATERAL COLLATERAL LIGAMENT

Abstract: Giant cell tumor of bone is a relatively common benign neoplasm, accounting for approximately 5% of all primary bone tumors. it predominantly affects adults in the second to fourth decades of life, with a predilection for the epiphyseal ends of long bones—most frequently the distal femur, proximal tibia, and distal radius. nonetheless, proximal fibular involvement by this tumor is infrequently documented and considered an unusual site of origin. this report presents a case of a 26-year-old male diagnosed with of the proximal fibula, emphasizing the surgical decision-making and post-operative outcomes we report an uncommon presentation of a giant cell tumor in the proximal fibula of a 26-year-old male. despite the typical benign nature of giant cell tumor, their occurrence in this anatomical region poses unique surgical challenges. the patient underwent the elective surgical procedure with the meticulous dissection of lateral compartment followed by the excision of tumor done with intraoperative identification and salvage of peroneal nerve and branches. notably, lateral compartment reconstruction was not performed. the surgical decision to forgo lateral collateral ligament reconstruction was taken as tumor is engorged in attachment of biceps femoris tendon. the lateral collateral ligament and biceps tendon were not reconstructed; instead, the surrounding lateral soft tissue structures were meticulously aligned and secured through layered suturing. the rehabilitation strategy included guarded weight-bearing and use of a brace. at the four-month follow-up, clinical evaluation revealed maintained knee stability and full mobility of the ankle and foot. this case exemplifies the importance of individualized surgical planning and highlights how selective omission of standard reconstructive procedures can still yield favorable functional and oncologic outcomes in rare Giant cell tumor locations. overall, early diagnosis, careful surgical planning, and long-term follow-up are essential to ensure favorable outcomes in patients with Giant cell tumor of the proximal fibula.