Central column reconstruction following total resection of a third metacarpal giant cell tumour.
A wide resection of a giant cell tumour involving the entire middle metacarpal is presented. Reconstruction preserving the central column and metacarpophalangeal joint was achieved using autologous iliac crest bone as a spacer and structural support. The fibro-osseous cartilage portion of the iliac graft was used as a "hemi-joint" replacement. By using a bridging bone graft and screw to fuse the adjacent proximal phalanges of the middle and index fingers, a stable "internal syndactyly" was achieved. Although independent index and middle finger motion was sacrificed, the approach allowed wide resection for local tumour control, re-established structural integrity, preserved metacarpophalangeal joint motion and allowed early motion. The aesthetic result was also good.
Lee
J Y L
JY
Department of Hand Surgery, Singapore General Hospital, Singapore, Department of Hand and Microsurgical Reconstruction, National University Hospital, Singapore. leeyiliang@pacific.net.sg
Pho
R W H
RW
Yeo
D S C
DS
D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D008279:Magnetic Resonance Imaging; D008663:Metacarpus / Q000601:surgery; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures