Der seltene Fall eines Riesenzelltumors des ersten Mittelfußknochens und dessen Rekonstruktion mit einem nicht-vaskularisierten, doppelläufigen Fibulatransplantat

Giant cell tumour is a benign bone tumor that is locally aggressive and prone to recurrence. Its predilection is primarily for long bones (85–90%) like tibia and distal radius, 4% in iliac bone, 2% in spine and 2% in the hand and foot. Metatarsal giant cell tumour is a rather rare condition, with only a few cases reported in the literature so far. The first metatarsal is the most important weight-bearing bone in the forefoot. Its reconstruction is significant to prevent future disabilities. The authors report a case of giant cell tumour of the first metatarsal in a 40-year old female. It was resected and reconstructed with double barrel non-vascularized fibular strut graft which has not yet been described in any of the previous cases. The anteroposterior and lateral diameters of the middle third fibula and the first metatarsal were compared using lower limb computerized tomography scans of six randomly selected patients. Functional outcome was evaluated using the Foot and Ankle Disability Index (FADI) score. The antero-posterior and lateral diameters of the first metatarsal were approximately twice the size that of the middle third fibula in both the limbs. With subsequent postoperative follow-up, the FADI score improved. The first metatarsal is a rare site for a manifestation of GCT. The diameter of the first metatarsal was twice that of the middle third of the fibula; non-vascularized double barrel fibular grafting may be an ideal choice for reconstruction to prevent future functional impairment.