Nora's lesion of 2nd metacarpal treated by wide excision, autologous fibular grafting and metacarpophalangeal joint replacement: A rare case report.

Bizarre paroxysmal osteochondromatous proliferation (BPOP) is a rare benign neoplastic lesion predominantly affecting small bones of the hand and known for its recurrence after local excision. We describe a rare case of BPOP involving second metacarpal of the dominant hand which was treated using a novel technique. Wide excision and reconstruction with non-vascularised fibular autograft was performed along with metacarpophalangeal joint replacement. At a follow up of two years, there was no evidence of recurrence and patient had good functional outcome. Hence this modality of treatment could be considered in dealing such cases of BPOP involving the small bones of hand.

Prevalence of skeletal deformity due to nutritional rickets in children between 1 and 18 years in tea garden community.

INTRODUCTION: The present study was undertaken to find out the prevalence of skeletal deformity due to nutritional rickets in children aged 1-18 years in tea garden community in Dibrugarh District of Assam. METHODOLOGY: It was a cross-sectional study and two-stage cluster sampling was used. In the selected tea gardens, all the children aged 1-18 years were screened for skeletal deformity by house-to-house visit. RESULTS AND OBSERVATIONS: The overall prevalence of skeletal deformity was 2.7 per thousand. Majority of children with deformities (57.27%) were between 7 and 12 years of age. Widening of wrists and ankle was the most frequent symptom (53.8%). Most of the children with deformity had moderate malnutrition (77.27%). Most of the children with skeletal deformity belong to lower (v) (45.45%) grade of Kuppuswamy's grading scale. Bilateral genu valgus deformity (54.54%) and bilateral genu varum (25.92%) deformity were the most common deformities. Widening of wrists and ankle was the most frequent symptom (61.66%). CONCLUSION: Of the 16,274 tea garden children included in our study (male and female) in the age group 1-18 years, 44 had skeletal deformity due to nutritional rickets. The prevalence of skeletal deformity due to nutritional rickets was found to be 2.7 per thousand children, which are significantly higher when compared with the only other such study, which was on general population in Bangladesh.