Case repository| Volume 44, ISSUE 5, P425.e1-425.e5, May 2019

Download started.


Metacarpal Aneurysmal Bone Cyst En Bloc Resection Reconstructed With Osteoarticular Allograft

      Aneurysmal bone cysts are large lytic lesions that appear most often around metaphyseal bone. The lesions are locally aggressive with high recurrence rates. Therefore, wide resection is commonly necessary, leading to challenging reconstruction of the defect, especially when the articular surface is involved. We present a case of an aneurysmal bone cyst of the fourth metacarpal, treated with an en bloc resection and reconstruction with a metacarpal osteoarticular allograft. At 8 years after surgery, the patient has shown no signs of recurrence, but radiographic articular reabsorption was noted. However, the patient showed an excellent outcome with a satisfactory active range of motion and grip strength. Despite potential complications, osteoarticular allograft is a feasible alternative when autologous osteoarticular reconstruction is not an option.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Athanasian E.A.
        Aneurysmal bone cyst and giant cell tumor of bone of the hand and distal radius.
        Hand Clin. 2004; 20: 269-281
        • Jafari D.
        • Jamshidi K.
        • Najdmazhar F.
        • Shariatzade H.
        • Liaghat O.
        Expansile aneurysmal bone cyst in the tubular bones of the hand treated with en bloc excision and autograft reconstruction: a report of 12 cases.
        J Hand Surg Eur Vol. 2011; 36: 648-655
        • Athanasian E.A.
        • McCormack R.R.
        Recurrent aneurysmal bone cyst of the proximal phalanx treated with cryosurgery: a case report.
        J Hand Surg Am. 1999; 24: 405-412
        • Frassica F.J.
        • Amadio P.C.
        • Wold L.E.
        • Beabout J.W.
        Aneurysmal bone cyst: clinicopathologic features and treatment of ten cases involving the hand.
        J Hand Surg Am. 1988; 13: 676-683
        • Ottolenghi C.E.
        Massive osteoarticular bone grafts: transplant of whole femur.
        J Bone Joint Surg Br. 1966; 48: 646-659
        • Smith R.J.
        • Brushart T.M.
        Allograft bone for metacarpal reconstruction.
        J Hand Surg Am. 1985; 10: 325-334
        • Crowe M.M.
        • Houdek M.T.
        • Moran S.L.
        • Kakar S.
        Aneurysmal bone cysts of the hand, wrist, and forearm.
        J Hand Surg Am. 2015; 40: 2052-2057
        • Rao G.S.
        • Keogh P.
        • Webster H.
        • Lunn P.G.
        • Burke F.D.
        Aneurysmal bone cysts in the hand treated by free non-vascularized transfer of metatarsal or proximal phalanx from the foot.
        J Hand Surg Br. 1993; 18: 736-741
        • Burkhalter W.E.
        • Schroeder F.C.
        • Eversmann Jr., W.W.
        Aneurysmal bone cysts occurring the metacarpals: a report of three cases.
        J Hand Surg Am. 1978; 3: 579-584
        • Athanasian E.A.
        • Bishop A.T.
        • Amadio P.C.
        Autogenous fibular graft and silicone implant arthroplasty following resection of giant cell tumor of the metacarpal: a report of two cases.
        J Hand Surg Am. 1997; 22: 504-507
        • Jones N.F.
        • Dickinson B.P.
        • Hansen S.L.
        Reconstruction of an entire metacarpal and metacarpophalangeal joint using a fibular osteocutaneous free flap and silicone arthroplasty.
        J Hand Surg Am. 2012; 37: 310-315
        • Pallapati S.C.R.
        • Thomas B.P.
        • Anderson G.A.
        En bloc excision and matched metatarsal transfer for expansive benign osteolytic lesions of the metacarpal.
        J Hand Surg Am. 2016; 41: 417-423
        • Kotwal P.P.
        • Nagaraj C.
        • Gupta V.
        Vascularised joint transfer in the management of recurrent giant cell tumour of the second metacarpal.
        J Hand Surg Eur Vol. 2008; 33: 314-316
        • Colen L.
        • Bunkis J.
        • Gordon L.
        • Walton R.
        Functional assessment of ray transfer for central digital loss.
        J Hand Surg Am. 1985; 10: 232-237
        • Pardo-Montaner J.
        • Pina-Medina A.
        • Barcelo-Alcaniz M.
        Recurrent metacarpal giant cell tumour treated by en bloc resection and metatarsal transfer.
        J Hand Surg Br. 1998; 23: 275-278
        • Innocenti M.
        • Adani R.
        • Boyer M.I.
        Nonvascularized osteoarticular allograft replacement of the proximal interphalangeal joint after extensive loss of bone, joint, and extensor tendon.
        Tech Hand Up Extrem Surg. 2007; 11: 149-155