Giant Cell Tumor of the Fourth Metacarpal Head in a Young Female Managed with Curettage, Hydrogen Peroxide, and Tricortical Iliac Crest Bone Graft with Kirschner Wire Fixation

Giant cell tumors (GCTs) of bone are rare, locally aggressive neoplasms, with metacarpal involvement being particularly uncommon. They present unique challenges due to the need for both oncological clearance and preservation of hand function. We report the case of a 19-year-old female who presented with swelling and pain over the head of the fourth metacarpal following trauma. Imaging and biopsy confirmed GCT. She was treated with intralesional curettage, chemical cauterization using hydrogen peroxide, reconstruction with tricortical iliac crest autograft, and fixation with an intramedullary Kirschner wire. Follow-up at 3, 6, and 12 months showed progressive graft incorporation, restoration of function, and absence of recurrence. This case demonstrates a rare and effective treatment strategy combining adjuvant hydrogen peroxide cauterization with tricortical iliac crest graft and intramedullary fixation in a metacarpal GCT.