title: A rare case of massive carpal osteoblastoma requiring complex reconstructive surgery.
abstract: An osteoblastoma is a rare, commonly benign, osteoid-producing neoplasm of the bone with an incidence of 2% of all primary bone tumours. We present a case of a 54-year-old patient with persisting carpal pain and massive swelling of the hand for a period of 4 years. Incision biopsies revealed the histopathological finding of a carpal osteoblastoma. After complete tumour excision, including the carpal and, in parts, metacarpal bones, reconstructive surgery was performed with a free osteocutaneous iliac crest flap to obtain a natural hand contour and the best possible hand function. Follow-up revealed improvement of the hand function in terms of flexion, extension and strength without discomfort or further pain. Thus, ongoing carpal pain should lead to an intensive search with further diagnostic measures such as magnetic resonance imaging (MRI) scan as well as biopsies, if necessary, to obtain the correct diagnosis.
authors.affiliation: Department of Plastic Surgery, Reconstructive and Hand Surgery, Burn Center, University Hospital Aachen, RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany. sdunda@ukaachen.de
authors.forename: S E
authors.initials: SE
authors.lastname: Dunda
authors.forename: J
authors.initials: J
authors.lastname: Kauczok
authors.forename: E
authors.initials: E
authors.lastname: Demir
authors.forename: T
authors.initials: T
authors.lastname: Braunschweig
authors.forename: N
authors.initials: N
authors.lastname: Pallua
mesh_terms: D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000601:surgery / Q000637:transplantation; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D050279:Metacarpal Bones / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D019637:Orthopedic Procedures / Q000379:methods; D018215:Osteoblastoma / Q000175:diagnosis / Q000601:surgery*; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D011884:Radius / Q000473:pathology / Q000601:surgery; D035583:Rare Diseases; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014457:Ulna / Q000473:pathology / Q000601:surgery; D014955:Wrist Joint / Q000503:physiopathology