Bizarre Parosteal Osteochondromatous Proliferation of the Little Toe

2006 ◽  
Vol 96 (2) ◽  
pp. 158-161 ◽  
Author(s):  
Baransel Saygi ◽  
Evrim Karadag-Saygi ◽  
Can Erzik ◽  
Murat Erkan ◽  
Yakup Yildirim
Keyword(s):  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Excisional Biopsy ◽  
Lateral Side ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Initial Examination ◽  
Histologic Diagnosis ◽  
Nora’S Lesion ◽  
Fifth Toe

A 19-year-old woman presented with pain at the lateral side of the fifth toe of her left foot, which was separated from the adjacent toe. Initial examination suggested dislocation of the fifth metatarsophalangeal joint due to a past fracture. Radiographs showed a mass arising from the proximal phalanx of the little toe, with no medullary and cortical continuity. Excisional biopsy of the mass was performed, and a histologic diagnosis of bizarre parosteal osteochondromatous proliferation of bone (Nora’s lesion) was made. (J Am Podiatr Med Assoc 96(2): 158–161, 2006)

scholarly journals Minimally invasive management of dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe

2011 ◽  
Vol 1 (2) ◽  
pp. 27
Author(s):  
Mariano De Prado ◽  
Pedro-Luis Ripoll ◽  
Pau Golanó ◽  
Javier Vaquero ◽  
Nicola Maffulli
Keyword(s):  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Invasive Technique ◽  
Wedge Osteotomy ◽  
Invasive Approach ◽  
Fifth Toe ◽  
Toe Deformity

Several surgical options have been described to manage persistent dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe. We describe a minimally invasive technique for the management of this deformity. We perform a plantar closing wedge osteotomy of the 5th toe at the base of its proximal phalanx associated with a lateral condylectomy of the head of the proximal phalanx and at the base of the middle phalanx. Lastly, a complete tenotomy of the deep and superficial flexor tendons and of the tendon of the extensor digitorum longus is undertaken. Correction of cock-up fifth toe deformity is achieved using a minimally invasive approach.

Bizarre Parosteal Osteochondromatous Proliferation (Nora's Lesion) of the Sesamoid: a Case Report

2000 ◽  
Vol 21 (5) ◽  
pp. 408-412 ◽  
Author(s):  
J.A. Harty ◽  
P. Kelly ◽  
D. Niall ◽  
J.C. O'Keane ◽  
M.M. Stephens
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Metatarsophalangeal Joint ◽  
Magnetic Resonance Images ◽  
Parosteal Osteosarcoma ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
First Metatarsophalangeal Joint ◽  
Histological Features ◽  
Nora’S Lesion ◽  
Plantar Aspect

We report the a case of Nora's lesion (Bizarre Parosteal Osteochondromatous Proliferation) of the sesamoid. A 32-year-old woman presented with a painless, enlarging mass of two years duration on the plantar aspect of the first metatarsophalangeal joint of the left foot. Radiographs, Computerized Tomographs and Magnetic Resonance images, initially suggested a parosteal osteosarcoma arising from the tibial sesamoid. The mass was excised, and a histological diagnosis of Bizarre Parosteal Osteochondromatous Proliferation of bone (Nora's lesion) was made. The aggressive growth of this lesion may suggest a neoplasm clinically. Histological features, however, are those of a reactive lesion.

scholarly journals Traumatic Hallux Varus Treated by Minimally Invasive Extensor Hallucis Brevis Tenodesis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
C. N. Cheung ◽  
T. H. Lui
Keyword(s):  
Minimally Invasive ◽  
Avulsion Fracture ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Lateral Side ◽  
Lateral Instability ◽  
First Metatarsophalangeal Joint ◽  
Hallux Varus ◽  
Adductor Hallucis

A case of traumatic hallux varus due to avulsion fracture of the lateral side of the base of proximal phalanx was reported. The lateral instability of the first metatarsophalangeal joint was believed to be due to the disruption of adductor hallucis function. It was successfully managed by minimally invasive extensor hallucis brevis tenodesis.

scholarly journals Nora’s lesion of the distal ulna: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110643
Author(s):  
Cheng Han Lin ◽  
Karl Wu
Keyword(s):  
Benign Lesion ◽  
Excisional Biopsy ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Distal Ulna ◽  
Nora’S Lesion ◽  
Calcified Lesion ◽  
Bone Cortex ◽  
Painless Mass ◽  
Hands And Feet

Nora’s lesion, also known as bizarre parosteal osteochondromatous proliferation (BPOP), is a very rare benign lesion with few published cases. BPOP is more common in adults during the second to third decades of life, and usually occurs on the hands and feet. Radiologically, it appears as a calcified mass attached to the bone cortex that grows rapidly and that recurs easily following resection. Aggressive features on imaging and confusing histopathological findings usually result in misdiagnosis or mistreatment. Herein, we present a case of a rare bony tumour involving the distal ulna presenting as a painless growing mass. An excisional biopsy with clear margins was performed without disturbing the ulnar nerve and arteries. There was no recurrent mass or calcified lesion 1 year after surgery. Based on its rarity and difficult diagnosis, BPOP should be considered in the differential diagnosis of a painless mass in the distal ulnar region. Careful follow-up after surgery is essential, even without lesion recurrence.

Irreducible metatarsophalangeal joint dislocation of the fifth toe in a child

The Foot ◽  
1994 ◽  
Vol 4 (2) ◽  
pp. 100-101 ◽  
Author(s):  
Mr A. Iossifidis ◽  
Mr R. Brueton
Keyword(s):  
Metatarsophalangeal Joint ◽  
Joint Dislocation ◽  
Fifth Toe

Measuring Visualized Joint Surface in Hallux Metatarsophalangeal Arthroscopy

2018 ◽  
Vol 39 (8) ◽  
pp. 978-983
Author(s):  
Michael Hull ◽  
John T. Campbell ◽  
Clifford L. Jeng ◽  
R. Frank Henn ◽  
Rebecca A. Cerrato
Keyword(s):  
Clinical Practice ◽  
Clinical Relevance ◽  
Articular Surface ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Lateral View ◽  
Joint Surface ◽  
Foot And Ankle ◽  
Kirschner Wires

Background: Arthroscopy has been increasingly used to evaluate small joints in the foot and ankle. In the hallux metatarsophalangeal (MTP) joint, little data exist evaluating the efficacy of arthroscopy to visualize the articular surface. The goal of this cadaveric study was to determine how much articular surface of the MTP joint could be visualized during joint arthroscopy. Methods: Ten fresh cadaveric foot specimens were evaluated using standard arthroscopy techniques. The edges of the visualized joint surface were marked with curettes and Kirschner wires; the joints were then surgically exposed and imaged. The visualized surface area was measured using ImageJ® software. Results: On the distal 2-dimensional projection of the joint surface, an average 57.5% (range, 49.6%-65.3%) of the metatarsal head and 100% (range, 100%-100%) of the proximal phalanx base were visualized. From a lateral view of the metatarsal head, an average 72 degrees (range, 65-80 degrees) was visualized out of an average total articular arc of 199 degrees (range, 192-206 degrees), for an average 36.5% (range, 32.2%-40.8%) of the articular arc. Conclusion: Complete visualization of the proximal phalanx base was obtained. Incomplete metatarsal head visualization was obtained, but this is limited by technique limitations that may not reflect clinical practice. Clinical Relevance: This information helps to validate the utility of arthrosocpy at the hallux metatarsophalangeal joint.

Surgical Outcomes and Predictive Factors of Medial Toe Excision for Polysyndactyly of the Fifth Toe

2020 ◽  
pp. 107110072097128
Author(s):  
Kyung Rae Ko ◽  
Jong Sup Shim ◽  
Jiwon Kang ◽  
Jaesung Park
Keyword(s):  
Surgical Outcomes ◽  
Proximal Phalanx ◽  
Case Series ◽  
Valgus Deformity ◽  
Retrospective Case ◽  
Functional Disturbance ◽  
Thickness Skin ◽  
Fifth Toe ◽  
The Mean

Background: We aimed to report surgical outcomes and analyze prognostic factors of medial toe excision for polysyndactyly of the fifth toe. Methods: We reviewed the details of 139 consecutive patients who underwent surgery for postaxial polydactyly of the foot from 2009 to 2018. Among these, 83 patients (90 feet) with polysyndactyly of the fifth toe, treated by medial toe excision (between the duplicated toes) and reconstruction of the fourth web space using a dorsal rectangular flap, were included. The toe alignment and stability were restored by chondroplasty and soft tissue balancing without an osteotomy. A full-thickness skin graft was performed in 52 feet. The mean age at surgery was 27.1 ± 17.5 months and the mean duration of follow-up was 42.8 ± 24.9 months. Results: At the last follow-up, a relatively small size of the reconstructed toe was observed in 19 feet (19/90, 21.1%). Proximal duplication level (metatarsal or proximal phalanx type) and preoperative hypoplasia of the remaining toe were related to the small postoperative size. Valgus deformity of the remaining toe was observed in 2 feet (2/90, 2.2%). We observed 17 cases with delayed healing or early postoperative wound infection. Among these, 7 cases (7/90, 7.8%) showed postoperative thickening or advancement of the web, which was not observed in cases without wound problems. No cases had functional disturbance or pain. Conclusion: The overall surgical outcomes were satisfactory without an osteotomy. Patients with a proximal duplication level or preoperative hypoplasia of the remaining toe should be informed of its possible small size postoperatively. Levels of Evidence: Level IV, retrospective case series.

scholarly journals Joint-Preserving Surgery for Hyperextension Deformity of the Hallux Interphalangeal Joint in a Patient with Rheumatoid Arthritis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Takumi Matsumoto ◽  
Yuki Shimizu ◽  
Song Ho Chang ◽  
Taro Kasai ◽  
Jun Hirose ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Wedge Osteotomy ◽  
Opening Wedge ◽  
Joint Preserving Surgery ◽  
Medial Cuneiform

Interphalangeal hyperextension is one of the major hallux deformities in patients with rheumatoid arthritis; however, there is yet no established surgical method for this deformity. We here present the case of a 69-year-old female patient with rheumatoid arthritis who developed hallux interphalangeal hyperextension and painful callosity on the plantar hallux accompanied by limited dorsiflexion at the metatarsophalangeal joint. Lateral weight-bearing radiograph of the foot revealed misalignment of the medial column and hallux, including a collapsed medial arch, elevated first metatarsal, plantar flexion and deviation of the proximal phalanx, and hyperextension of the distal phalanx. The foot was successfully treated and became symptom-free with opening wedge osteotomy of the medial cuneiform, plantar and proximal translation of the metatarsal head, and tenotomy of the extensor hallucis longus. This case suggests that reconstruction of the sagittal alignment of the medial column and hallux through a combination of osteotomy and soft tissue intervention could be an optional treatment for interphalangeal hyperextension.

Surgical Treatment of Patients with Painful Instability of the Second Metatarsophalangeal Joint

1998 ◽  
Vol 19 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Andre Gazdag ◽  
Andrea Cracchiolo
Keyword(s):  
Hallux Valgus ◽  
Stress Test ◽  
Excellent Result ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
Joint Stability ◽  
Hallux Valgus Deformity ◽  
Flexor Digitorum ◽  
Second Toe

An unstable second metatarsophalangeal joint may produce pain in the forefoot. Eighteen patients (20 feet) had a transfer of the flexor digitorum longus to the extensor side of the base of the proximal phalanx performed as the primary procedure to stabilize this painful joint. Most patients had a hallux valgus deformity that also required correction, because it either was also symptomatic or was preventing adequate reduction of the second toe. A ruptured plantar plate of the second metatarsophalangeal joint was demonstrated in 13 feet and in these joints appeared to be the cause of the vertical instability. However, all feet showed an unstable joint upon clinical examination. A vertical-stress test almost always reproduced the patient's pain while demonstrating instability in the joint; this was the most prominent physical finding in these patients. Eleven patients (13 feet) had an excellent result. Seven patients (seven feet) had a fair result, but they complained only of mild and occasional pain at the joint on exertion. Although difficult to quantify, it appears that postoperative stiffness in the joint provided some of the joint stability seen in our patients. The flexor tendon transfer appears to be a satisfactory method to treating the unstable metatarsophalangeal joint and of relieving patients' pain, but may not, however, restore a normal alignment of the second toe. Correction of other forefoot deformities as hallux valgus and hammertoes may also be important in restoring metatarsophalangeal stability.

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