Exceptionally Extensive Trevor's Disease Involving All Four Radial Carpals Presenting With Gross Wrist Deformity

累及全部四根桡侧腕骨的特大范围特雷弗氏病,表现为严重的腕关节畸形

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Abstract

Trevor's disease, also known as dysplasia epiphysealis hemimelica (DEH), is an uncommon developmental disorder in which the epiphyseal cartilage grows asymmetrically, typically affecting the lower limbs. Carpal involvement is exceptionally uncommon. We report a four-year-old girl presenting with a progressively enlarging, firm swelling over the volar-radial aspect of the wrist, causing deformity and restricted motion. Imaging revealed multilobulated osteocartilaginous lesions involving the scaphoid, lunate, trapezium, and trapezoid, as well as an additional lesion within the abductor pollicis longus tendon sheath. Histopathology confirmed the diagnosis of DEH. Surgical excision with deformity correction resulted in good functional recovery without recurrence at six months. This rare case of extensive, multilobulated carpal DEH underscores the importance of recognizing its epiphyseal origin to differentiate it from osteochondroma and guide appropriate management.

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