eMedicine Specialties > Orthopedic Surgery > Neoplasms

Dysplasia Epiphysealis Hemimelica: Treatment

Author: Khalid A Bakarman, MD, MB, BCh, SBIO, Pediatric Orthopedic Consultant, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia
Coauthor(s): Robert Mervyn Letts, MD, FRCS(C), FACS, Former Chief, Department of Surgery, Division of Pediatric Orthopedics, Children's Hospital of Eastern Ontario, University of Ottawa; Consultant Pediatric Orthopedic Surgeon, Sheikh Khalifa Medical City, UAE
Contributor Information and Disclosures

Updated: May 12, 2008

Treatment

Medical Therapy

Supportive joint care, consisting of short-term splinting of the joint, may be beneficial.

Surgical Therapy

Most reported cases of DEH in the literature have been treated surgically, with surgical treatment consisting of excision of the mass, as well as correction of any angular deformity, while preserving the integrity of the affected joint as much as possible.22,23

Follow-up

After surgery, the affected limb requires a short period of immobilization with a cast or splint, followed by active range of motion of the joint.

Complications

  • Recurrence of the angular deformity after the corrective osteotomy - May be anticipated if the growth plate at the affected joint is open and active and the lesion itself has not been removed20,24
  • Degenerative osteoarthritis
  • Fixed deformity
  • Leg-length discrepancy4,24,25
  • Loose bodies

More on Dysplasia Epiphysealis Hemimelica

Overview: Dysplasia Epiphysealis Hemimelica
Workup: Dysplasia Epiphysealis Hemimelica
Treatment: Dysplasia Epiphysealis Hemimelica
Follow-up: Dysplasia Epiphysealis Hemimelica
Multimedia: Dysplasia Epiphysealis Hemimelica
References
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References

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Further Reading

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Keywords

DEH, Trevor disease, Trevor's disease, tarsoepiphyseal aclasis, tarsomegalie, joint swelling, swollen joint, swollen knee, swollen ankle, talus, tarsal joint, navicular joint, cuneiform joint, articular osteochondroma

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Contributor Information and Disclosures

Author

Khalid A Bakarman, MD, MB, BCh, SBIO, Pediatric Orthopedic Consultant, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia
Disclosure: Nothing to disclose.

Coauthor(s)

Robert Mervyn Letts, MD, FRCS(C), FACS, Former Chief, Department of Surgery, Division of Pediatric Orthopedics, Children's Hospital of Eastern Ontario, University of Ottawa; Consultant Pediatric Orthopedic Surgeon, Sheikh Khalifa Medical City, UAE
Disclosure: Nothing to disclose.

Medical Editor

Howard A Chansky, MD, Associate Professor, Department of Orthopedics and Sports Medicine, University of Washington Medical Center
Howard A Chansky, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Sean P Scully, MD, PhD, Professor, Department of Orthopedics, University of Miami
Sean P Scully, MD, PhD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, International Society on Thrombosis and Haemostasis, and Society of Surgical Oncology
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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