ABSTRACT
Dysplasia epiphysialis hemimelica (DEH), also known as Trevor disease, is a very rare disease characterized by an overgrowth of the osteocartilaginous epiphyseal caused by unknown factors. The medial side of the epiphysis is affected twice as often as the lateral side and more than one epiphysis was affected in two-thirds of the cases. Only a few cases of DEH in the upper extremities have been published, as the lower limb is usually the most affected, especially in the bones of the ankle joint. The symptoms vary from little significant deformities to symptomatic cases, pain, and decreased function depending on the location and the size of the lesion. When surgery is indicated, the complete excision of the lesion is the procedure of choice. If this is not possible, because of the location or size of the lesion, a realignment osteotomy may be necessary. We report the case of a 12-year-old patient with a distal epiphysis DEH on the left radius, treated by wedge osteotomy realignment at the level of the lesion with Kirschner wires. The clinical outcome of realignment osteotomy of the radial epiphysis has been the correction of the deformity with a normal and painless function of the wrist and hand. The case reported was an extremely rare location in the distal radial epiphysis of DEH. We are aware of only one case published previously with involvement of the distal radius in children. The surgical treatment of realignment osteotomy without complete removal of the lesion has enabled anatomical and functional improvement of the joint as well as a reduction in lesion size. LEVEL OF EVIDENCE: Level IV case report.
Subject(s)
Bone Diseases, Developmental/surgery , Osteotomy/methods , Radius/abnormalities , Wrist Joint/abnormalities , Child , Humans , Male , Treatment OutcomeABSTRACT
Presentamos un caso de conversión de artrodesis de cadera en artroplastia total de cadera como consecuencia de la aparición de lesiones por mieloma múltiple a nivel de cabeza y cuello femoral. La justificación del caso es la presentación del cuadro dándose en la misma localización un tumor blanco por tuberculosis y años después una lesión mielomatosa que finalmente posibilitó al paciente la recuperación de su capacidad funcional perdida como consecuencia de la artrodesis. Se hace hincapié en la singularidad del caso, no habiéndose encontrado en la literatura ninguna publicación donde la indicación de la desartrodesis se haya basado en la aparición de un nuevo tumor (AU)
Carpal tunnel syndrome (CTS) is the most commoA case is presented of hip arthrodesis conversion in a total hip arthroplasty as a consequence of injuries due to multiple myeloma in the femoralhead and neck. This case is interesting due to the fact that a white tumor caused by tuberculosis appeared in the same site; years later, a myelomatose injuryfi nally gave the patient the possibility of recovering the functional capacity lost as a consequence of the arthrodesis. The case is extremely unique, as the literature offers no information in which the indication of desarthrodesis was based on the appearance of a new tumor (AU)
