Giant cell reparative granuloma (GCRG) is benign, non-tumorous granulation tissue. It mainly arises in the jaw bone and occasionally in the hand and foot. Because of the high rate of recurrence, wide surgical resection and autologous bone grafting are recommended. However, this can be problematic for hand function. We present a case report of a 16-year-old boy with a GCRG of the fifth metacarpal bone and the diagnostic difficulties. To treat the patient, we performed a wide resection with the interposition of a corticocancellous bone graft and plate osteosynthesis. 24 months postoperatively the patient shows no signs of recurrence and has good hand function.

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