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Introduction. The aneurysmal bone cyst is a benign bone tumor with a low incidence. Its presence within the bone of the hand is quite unusual. When it comes to its evolution, it is known to be an aggressive tumor with a progressive weakening of the bone structure. Objective. This case report aimed to present the importance of keeping the hand function intact for patients who are usually in their first decades of life. As a reconstruction method, a radical surgical approach and grafting are both mandatory for the unit to have the mobility unaltered. Material and methods. It is a case of a 15-year-old male with a giant aneurysmal bone cyst of the fifth metacarpal bone of the left hand. This tumor was surgically removed and the entire bone was rebuilt with an autologous bone graft from the iliac crest. The articular surface was preserved for the distal joint (the head of the metacarpal bone was spared). Results. The surgical procedure concluding the resection and immediate grafting reestablished the function of the hand with no infirmity, and the results for the past 7 years after surgery kept being negative for relapse and the patient had great mobility within the segment. Conclusions: The proper and correct surgical treatment of giant aneurysmal bone cyst located on the fifth metacarpal bone is the mandatory resection of the entire tumor for the high risk of pathological bone fracture with a severe impact on the mobility of the hand.

Delayed breast reconstruction after irradiated mastectomy cases includes a large series of reconstructive procedures like silicone implant/expander, numerous flaps or combined methods. Bad status of irradiated tissues needs to find a way to ensure a stable breast feature. Latissimus dorsi myocutaneous flap with implant represents one of classical methods of breast reconstruction providing a new breast with superior appearance. The aim of this paper is to present the advantages of breast reconstruction with latissimus dorsi flap and silicone-filled implant. New breast is created by combining the silicone implant placed under pectoralis major muscle and latissimus dorsi myocutaneous flap. Markings of flap is performed with the patients in standing position; first the new inframammary fold and midline and on back the skin paddle is design after a pinch test to check the amount available and the future donor site closure. It is recommended to place the incisions in transverse position so that the scar to be hidden in bra line. The study includes 84 patients who underwent breast reconstruction from April 2014 to April 2016. 57 were latissimus dorsi flap with implant and 5 from which were for salvage another breast reconstruction. The patient’s age was average between 32 and 69 years. The implants used were round shape implants, silicone filled with micro-textured shell. Combination between autologous tissue and implant offer superior appearance of new breast with shape, volume, natural ptosis and consistency similar with normal breast. Also, fast recovering and socio-professional reintegration are the benefits of this method. Analyzing different surgical option, breast reconstruction with latissimusdorsi flap and silicone implant seems to offer very good results with minimum complications in such difficult cases. This method can be suitable for almost all irradiated postmastectomy cases.