1. INTRODUCTIONA giant cell tumor (GCT) is a benign neoplasm characterized by progressive and destructive features. Typically manifesting in individuals during their third or fourth decade of life, GCT exhibits a higher prevalence in women than in men. Although categorized as a benign bone tumor, GCT displays local aggressiveness and a propensity for recurrence (1). Accounting for approximately 6% of all bone tumors, 4% of primary bone tumors, and 20% of benign bone tumors, GCTs are relatively uncommon. The distal femur, proximal tibia, and distal radius are the most frequently affected long bones, with a particular predilection for the distal end of the radius, making it the third most common location for GCT after the distal femur and proximal tibia. Despite their benign classification, GCT can exhibit local aggressiveness, causing bone erosion, pain, and potentially leading to fractures (2).GCT or osteoclastoma, is a rare yet locally aggressive primary bone tumor characterized by multinucleated giant cells dispersed throughout the tumor, along with mononuclear stromal cells producing osteoid matrix. Histologically, GCT exhibits areas of hemorrhage and necrosis indicative of its aggressive nature, and in some cases, increased mitotic activity (3). The stromal cells often generate fibrous bands and septae, contributing to tumor compartmentalization. Histological grading based on features like mitotic activity guides prognosis, with higher grades associated with increased recurrence rates. Immunohistochemistry, utilizing markers such as CD68, CD163, and RANKL, aids in distinguishing GCT from other bone tumors. Understanding these histopathological features is crucial for accurate diagnosis and management decisions, which often involve a multidisciplinary approach tailored to the tumor’s behavior and grade (4).GCTs pose a challenge in terms of management, especially when located in the distal radius. En bloc resection, a surgical technique involving the removal of the tumor along with a margin of surrounding normal tissue, is often employed in cases of large, aggressive, or challenging-to-reach tumors. This method aims to reduce the risk of local recurrence (5). However, the optimal approach for treating GCTs of the distal radius remains controversial, with en-bloc excision showing decreased recurrence but posing challenges for wrist reconstruction due to the complex functional requirements of the wrist (6). The multidisciplinary management of GCTs involves various treatment options such as curettage, cryotherapy, radiation therapy, monoclonal antibody therapy (Denosumab), and surgery. Recurrence rates after surgical treatment may vary based on factors like tumor location, extent of surgical resection, and patient age. Distal ulna and radius have been reported as especially susceptible to GCT recurrence after resection (7).This study aims to provide a comprehensive overview of different reconstruction techniques employed after en-bloc resection of GCTs in the distal radius, acknowledging the controversies and varied opinions among orthopedic oncologists on the most effective strategies for managing long bone defects.