case_images: PMC8046473_01
case_images: Clinical photograph of the patient at presentation.
case_images: JOCR-11-101-g001.jpg
case_images: PMC8046473_01_JOCR-11-101-g001.jpg
case_images: F1
case_images: On examination, there was an extension lag at the middle finger, poor grip strength, and reduced height of middle ray (Fig. 1).
case_images: Radiograph of the affected hand at the time of initial presentation.
case_images: JOCR-11-101-g002.jpg
case_images: PMC8046473_01_JOCR-11-101-g002.jpg
case_images: F2
case_images: The X-ray showed pathological fracture of third metacarpal with osteolytic lesion involving base of second metacarpal and carpal bones (Fig. 2).
case_images: Magnetic resonance imaging images of the hand.
case_images: JOCR-11-101-g003.jpg
case_images: PMC8046473_01_JOCR-11-101-g003.jpg
case_images: F3
case_images: It also showed pathological fracture involving capitate with patchy areas of osteolysis (Fig. 3).
case_images: Serial radiographs showing progressive osteolysis.
case_images: JOCR-11-101-g004.jpg
case_images: PMC8046473_01_JOCR-11-101-g004.jpg
case_images: F4
case_images: Serial X-rays taken at 4 weeks, 8 weeks, 12 weeks, 18 weeks, and 6 months revealed that there was progressive concentric reduction of metacarpal shaft, first involving third then fourth metacarpal giving appearance of a sucked candy (Fig. 4).
case_images: Immediate post-operative radiograph.
case_images: JOCR-11-101-g005.jpg
case_images: PMC8046473_01_JOCR-11-101-g005.jpg
case_images: F5
case_images: Non-vascularized fibular autologous graft was harvested from the ipsilateral limb and fixed with transverse k-wires to adjacent metacarpal (Fig. 5).
case_images: Radiograph at 2-year follow-up showing well incorporated of the fibular graft.
case_images: JOCR-11-101-g006.jpg
case_images: PMC8046473_01_JOCR-11-101-g006.jpg
case_images: F6
case_images: At the end of 2 years, graft was completely incorporated (Fig. 6) and the patient gained functional recovery (Fig. 7) with active flexion at metacarpophalangeal joints of the 3rd and 4th finger from 0 to 70  and normal range at proximal interphalangeal (PIP) joint (0-100 ) and DIP (0-80 ) joints.