Surgical treatment for dysplasia epiphysealis hemimelica in children

Abstract

Objective To evaluate the result of early stage and mid-term follow up of dysplasia epiphysealis hemimelica in children. Methods Twenty six patients with dysplasia epiphysealis hemimelica who were treated in our hospital from 1999 to 2008 were retrospectively reviewed. We analyzed the diagnosis, surgical indications, surgical options, surgical skills and the relationship between these factors and the prognosis. Results The range of movement of joint in 15 patients was improved significantly in follow up. Limb deformity in 5 patients was improved significantly after surgery. The joint function had no improvement however. 3 patients had progressive limp resulting from poor joint function. One patient's knee was stiff and fixed in flexion 25 degree. Serious avascular necrosis of talus developed in one patient that caused in limp and ankle valgus. Seven patients were re-operated. They included limb equilibrium surgery in 3 patients, reoperation for incomplete tumor removal in 2 patients, and osteotomy in 2 patients. In short, the shorter symptoms, the better then treatment. Conclusions Current treatment principle for this disease is early diagnosis and treatment to prevent the malignant change. Key words: Child; Dysplasia epiphysealis hemimelica; Epiphyses