Module 31, General Medical Level

This 3 year boy presented with shortening of the right humerus. Clinical examination revealed 4 cm shortening of right arm and painless limitation of ROM of right shoulder; abduction was 150 degrees with 80 degrees at the glenohumeral joint and internal rotation was significantly limited. There was also a 1 cm shortening of the right leg and a 10 degree valgus deformity of the same knee. Radiological examination showed absence of proximal epiphysis of the right humerus with marked deformity of the metaphyseal region.

Question 31A

This represents a congenital deformity of the tibia and humerus.

Question 31B

At the conclusion of growth the absolute difference in the limb lengths will only increase slightly.

Question 31C

The cause of this deformity could have possibly been avoided..

Question 31D

The limb length discrepancy of the upper extremity will not be a functional problem.

Question 31E

Physical therapy should now be ordered to improve the shoulder range of motion.