Nora's Lesion: Bizarre Parosteal Osteochondromatous Proliferation Causing Splay Foot Deformity: A Case Report

Nora's lesion, or bizarre parosteal osteochondromatous proliferation (BPOP), is a rare benign lesion that is made up of varying degrees of cartilage, bone, and spindle cells. Most notably, calcification of the cartilage or “blue bone,” is a feature of the disorder. The condition principally affects long tubular bones of the hands and feet, and is generally seen in patients in their second and third decades of life. We present a case of BPOP occurring in the second interspace with symptoms that would be consistent with a more common diagnosis of predislocation syndrome, or a second interspace neuroma. This case study may help the clinician in considering a more subtle cause of a splay deformity in the second interspace, and walk through the diagnostic and treatment course for BPOP.

First and Second Metatarsal Wire and Button Fixation with First and Fifth Bunionectomies for Correction of Splay Foot

ABSTRACT Splay foot is a common foot deformity causing pain and disability. Various osteotomy techniques have been recommended for correction of the intermetatarsal angle, with variable success rates. Knowing that wire and button fixation device can provide strong and stiff repair, the aim of the present study was to assess the clinical and radiographic outcomes following 1st and 2nd metatarsal wire and button fixation with 1st and 5th bunionectomies in patients with symptomatic splay foot. The preoperative and postoperative radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) scores were statistically assessed in 12 patients (19 feet) with symptomatic splay foot using Wilcoxon signed rank test. The postoperative hallux valgus angle, 1st and 2nd intermetatarsal angle, and maximum distance between 1st and 5th metatarsal heads decreased significantly (p < 0.05). The AOFAS score improved significantly from 49.0 ± 6.0 to 82.0 ± 5.0 points (p < 0.05). The overall postoperative radiological and clinical outcomes in patients with symptomatic splay foot suggest that the technique of 1st and 2nd metatarsal wire and button fixation with 1st and 5th bunionectomies is safe, feasible and effective for surgical treatment of splay foot deformity. How to cite this article Xie B, Zhou D-P, Tian J. First and Second Metatarsal Wire and Button Fixation with First and Fifth Bunionectomies for Correction of Splay Foot. J Foot Ankle Surg (Asia-Pacific) 2015;2(1):1-7.