The remodeling potential of a long bone to correct posttraumatic angular deformities during infancy is widely recognized1-5; however, no consensus has yet been reached as to the remodeling potential of a long bone to correct rotational deformities4,6,7. To the best of our knowledge, the present report is the first to document the long-term radiographic and functional follow-up of a patient who had proximal humeral epiphysiolysis with marked rotational deformity due to birth trauma. Our patient was informed that data concerning the case would be submitted for publication.
Agirl weighing 3420 grams was delivered after thirty-nine weeks of gestation to a primiparous mother in an obstetrics clinic. The baby presented in the double footling breech position. The right upper extremity was forcibly manipulated because it was caught by the umbilical cord during the vaginal delivery. On the day following birth, the infant did not move the right arm and cried on passive movement of that extremity. On the third day after birth, a radiograph made at the obstetrics clinic revealed a fracture of the right clavicle (Fig. 1). Because the mother later noticed that the child had a limitation of adduction and internal rotation of the right shoulder, the infant was examined on the thirteenth day after birth at an orthopaedic clinic and radiographs made there showed callus around the proximal aspect of the humerus.
The patient was examined at our clinic on the following day. She maintained the right shoulder in an abducted and externally rotated position, and a deep cleft was visible in the skin of the lateral shoulder. A hard mass was palpable in the anteromedial aspect of the shoulder, and the humeral head was palpable under the acromion. An osseous mass, 2.5 cm in diameter, was noted …
Enter your JBJS login information below.
Please note that your username is the email address you provided when you registered.