Paras Hospitals Treats Rare Wrist Tumour with New Surgery; Prevents Limb Amputation of NSG Personnel’s Brother

Gurgaon. The 39-year-old Dwipen Krishnan Sarania was playing badminton when he felt stiffness in his wrist, the area was swelled and he could feel a pulsating sensation.

To his utter dismay and shock, the doctors at Paras Hospital, Gurgaon diagnosed a giant cell tumour in his wrist which was benign in nature, and not life threatening but it was limb threatening for sure. It is a rare tumour of the bone under the skin which had escalated from Grade I to Grade III. Unless removed surgically, it may have led of amputation of the limb.

The attending Orthopaedic doctors of Paras Hospitals who successfully treated this rare case of wrist tumour, cautioned that a swelling and pulsating sensation in the wrist area might not only indicate an injury but could be a symptom of a tumour as well.

A team of Orthopaedic doctors of Paras Hospitals treated the case of rare wrist tumour with a new, complex surgical procedure and saved the amputation of the limb, comprising by Dr. Arvind Mehra, Chief of Orthopedics and Trauma and Dr. Kandarp Vidhyarthi, Consultant, Department of Orthopedics and Trauma, Paras Hospitals, Gurgaon.

While playing badminton, 39-year-old Dwipen Krishnan Sarania, brother of an NSG personnel, suddenly felt stiffness in his wrist – the area was swelled and though it was not painful, he could feel a pulsating sensation. He consulted a doctor who conducted a biopsy and gave intravenous treatment.

However, the patient’s brother, who is an NSG personnel, discussed the case with an Orthopaedic doctor of Paras Hospitals at the on-site OPD there who referred the case to Dr. Mehra as the tumor progressed from Grade I to Grade III.

“We conducted X-rays and CT scan in addition to the biopsy to diagnose the right condition of the patient. The results were shocking – it was a giant cell tumour, underneath the skin in muscle planes and has escalated from Grade 1 to Grade 3. This was a very serious development as it may lead to amputation of the limb and only surgery could have prevented the tumour from spreading any further. We conducted a two-hour long, complex surgery termed ‘ENBLoc Excision of Distal Radius with Centralization of Ulna and Ulnocarpal Arthrodesis’ and removed the tumour with no further complications,” said Dr. Arvind Mehra, Paras Hospitals, Gurgaon.

“We had to remove the radius bone near the wrist because the tumor had destroyed the distal radius and dissected a piece of the ulna, a long bone in the forearm that stretches from the elbow to the Wrist Joint, to support the wrist. The surgery was complex as it comprised more than one processes but we could carry out with perfection due to meticulous planning and vast experience in similar cases. This was a very rare case due to its severity and such a complex tumour was treated with a new technique which could preserve the functionality of the right hand. In the days to come, this is expected to give excellent results to the patient in a single surgery and in a cost-efficient manner,” added Dr. Mehra.

Dwipen Sarania was in the hospital for three days and was discharged after satisfactory recovery. Correct advice and timely intervention saved him from amputation, doctors say.

According to Dr. Mehra, such a tumour develops in younger age between 20 and 40 years and could happen to anyone, was not restricted to the sportspersons only.

Why the surgery was unique?  Dr. Mehra said one of the options from the textbooks was to take a bone graph from the leg and put it on the part of the wrist from where we have to remove the tumour.

“But this process results into weakness in the leg from where we take the bone from as it involved surgery of another limb too. Second, it also leads to stiffening of the wrist joint. But the new technique which is not reported in the textbooks, there are two bones in the forearm where once we remove one bone, we replace that bone with the second bone which is in the forearm. With this, the surgery is only in one limb. We also have 70 percent function of the wrist joint but not if we take bone from the leg. This process has been conducted successfully for the first time in Delhi and NCR towns,” Dr. Mehra told Asian Community News (ACN) Network.