Chondromyxoid Fibroma of the Right Thumb: Successful Management with Wide Local Excision, Iliac Crest Bone Grafting and K-Wiring – A Rare Case Report

Introduction: Chondromyxoid fibroma (CMF) is a rare, benign cartilaginous tumor that typically affects long bones but rarely involves the small bones of the hand. This case report presents a unique occurrence of CMF in the right thumb, managed through surgical resection, K-wiring, and iliac crest bone grafting (ICBG). Case Report: A 51-year-old male presented to our facility with complaints of pain and swelling at the base of his right thumb, persisting for 2 months. The pain was initially managed with home remedies. However, the patient noted progressive swelling after 1 month, prompting him to seek medical attention. Physical examination and imaging studies revealed a mass involving the first metacarpal. A lazy-S incision was made over the affected area. Wide local excision of the tumor in the 1st metacarpal with preservation of endplates, along with the involved first metacarpal, was performed. A tri-cortical graft from the iliac crest, shaped to match the defect, was then placed, and stabilization was achieved using four K-wires under C-arm guidance in a cross configuration. CMF in the hand is rare, and its presence in the thumb poses unique challenges for both diagnosis and treatment. While CMF is typically benign, its local recurrence rate warrants careful surgical planning and follow-up. Resection with structural grafting and K-wire fixation in this case allowed for effective restoration of thumb stability and function. Conclusion: This case demonstrates successful management of thumb CMF through wide local excision of the tumor of the 1st metacarpal with preservation of endplates, tri-cortical ICBG, and K-wire fixation. The patient is expected to regain functional use of the thumb, emphasizing the importance of tailored surgical approaches in rare tumor presentations. Keywords: Chondromyxoid fibroma, thumb tumor, iliac crest bone graft, K-wire fixation, rare case.