Reconstruction of a Base of Fifth Metacarpal Tumor Using the Dubert Procedure: A Case Report.
Nirbhay S Jain, Kurt Weiss, Dana E Bregman
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Case in brief
A 63-year-old right-hand-dominant man was referred for reconstruction after intralesional resection of a myopericytic neoplasm at the base of the left fifth metacarpal. The lesion had recurred locally multiple times despite serial curettage and calcium phosphate grafting, leading to resection of the metacarpal base. The fifth metacarpal shaft was fused to the fourth with autogenous bone graft to prevent subsidence while preserving motion. At 6-month follow-up, the metacarpals had fused, with good motion and grip strength.
What made this case unusual
The reconstruction addressed loss of the fifth metacarpal base by fusing the fifth metacarpal shaft to the fourth, aiming to maintain stability without sacrificing motion.
Diagnostic / clinical pearl
After resection of the fifth metacarpal base, fourth-to-fifth metacarpal shaft fusion with autogenous bone graft can provide stability while preserving motion, as demonstrated in this case.