Total Metacarpal Reconstruction with Fascia-Wrapped Fibular Graft Following Ewing Tumor Resection in a Growing Patient

Abstract

Ewing tumor, a rare bone tumor, exceptionally affects the hand. We report a unique case of this tumor in the fourth metacarpal of a young patient. Reconstructing a digit after complete metacarpal removal because of sarcoma resection is a complex challenge, especially in growing individuals. We employed a novel technique involving a nonvascularized fibular autograft wrapped in fascia and intricate soft tissue reconstruction for proximal phalanx growth. The patient’s function remained satisfactory for more than 2-year follow-up.

Keywords

• Case report
• Ewing tumor
• Fibula graft
• Metacarpals
• Reconstructive surgery
• Wide local excision