Abstract
A 36-year-old female with recurrent giant cell tumor (GCT) of the left fifth metacarpal was treated with en bloc resection and free osteoarticular metatarsal graft from the fourth metatarsal. Donor site management involved primary closure without bone reconstruction. The patient experienced excellent functional outcomes at 2-year follow-up, with a stable metacarpophalangeal joint and an active range of motion of 0-80 deg. No donor site complications were reported, and radiographs demonstrated successful graft incorporation and preserved joint space. The simplified donor site management reduced surgical complexity without compromising outcomes. Free osteoarticular metatarsal graft of the fourth metatarsal offers a function-preserving option for managing recurrent GCT of the hand, with minimal morbidity and durable results.