Dysplasia Epiphysealis Hemimelica of the Talus: Two Case Reports

Abstract

Trevor's disease, also known as dysplasia epiphysealis hemimelica, is an uncommon skeletal developmental disorder representing an osteochondroma occurring in one or more epiphyses. We present 2 cases of dysplasia epiphysealis hemimelica in an 8-year-old female and a 12-year-old male who suffered from a hard swelling of the ankle joint. The female patient was treated by surgical excision and the male patient conservatively.

Trevor’s Disease: A Literature Review regarding Classification, Treatment, and Prognosis apropos of a Case

“…Even though OC is the most common of all benign bone tumours and represents 10% to 15% of all bone tumours, DEH is rarer. DEH has a reported incidence of 1 : 1.000.000 [17, 18]. Despite DEH's rarity, including our case, 73 authors have reported 144 cases from 1926 to 2013.…”

“…The age of 8 is also typical for first presentation. Most of the cases appear between the ages of 2 and 8 but cases have been reported in patients from 2 months to 40 years old [8, 18, 22–24]. …”

“…If the lesion is treated nonoperatively, careful followup is indicated in order to evaluate the progression of the lesion. Massive ossification of the hypertrophic cartilaginous areas [26] within 4 years and early osteoarthritis of the ankle [18] in 2 years have been reported.…”

Acutely presenting kissing lesions of the ankle: an atypical Trevor's disease and literature review of other unusual presentations of the disease

“…He also speculated that the peculiarity in vascular arrangement of the epiphysis was responsible for the tendency of this lesion to be asymmetrically confined to only one side of the joint, preferentially the medial side 6. Bhosale et al ,8 in 1933, conjectured that the cartilage of an epiphysis of a long bone is formed from a narrow zone ‘mitotic annulus’, where cartilage cells are actively dividing. These cells in the mitotic annulus eventually disintegrate, and together with the matrix they give rise to the main constituent of synovial fluid.…”

Dysplasia epiphysealis hemimelica: a huge articular mass with unpredictable surgical results

“…Bhosale et al 13 suggested excision if the lesion caused disability and arthrodesis of the ankle may be appropriate with extensive involvement of the talus. Trevor3 and Kettelkamp et al 14 suggested an arthrodesis for patients developing degenerative joint disease.…”