Satisfactory outcome of autologous fibular grafting following reconstruction in giant cell tumour of first metacarpal

Although benign, Giant cell tumour (GCT) of the bone is a locally aggressive lesion, commonly affecting the epiphy- seal ends of long bones after skeletal maturation. In the hand bones, GCT runs a further rapid course, often showing whole bone involvement and cortical breach at presentation, along with significant functional deficit. The extent of the tumour at the time of diagnosis and the high recurrence rate reported after simple curettage or limited resection often dictate the need for an en bloc resection through normal tissues. The first metacarpal represents a rare site for GCT occurrence, and also a challenging reconstructive problem after such treatment. Among the various available treatment options aimed at preserving metacarpophalangeal joint mobility include metatarsal substitution, a combined iliac crest and metatarsal head graft and prosthetic replacement. However, in patients with low functional demands, simple substitution with a fibular autograft can provide satisfactory results.