PMC2808566_01
Preoperative photograph and radiographs. (A) The right humerus is 5 cm shorter than the contralateral side at the age of 8 yr and 10 months. (B) Humerus varus deformity is observed on the right side. (C) All the metacarpals and phalanges are short and thick. (D) Brachymetatarsia of the 3rd, 4th and 5th resulting from premature physeal closure is observed.
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F1
The distance from the acromion to the cubital crease measured 16 cm on the right side and 21 cm on the left side (Fig. 1A). Radiographic examination showed that the round but flattened humeral head was retroverted with a varus orientation (Fig. 1B). All of the metacarpals and the phalanges of the hand were short and broad with coned epiphyses, while the 3rd, 4th and 5th metatarsals were short as compared with the 1st and 2nd metatarsals (Fig. 1C, D).
Photographs and radiograph at the 4 yr follow-up. (A) Radiograph of the right humerus 4 yr after the operation. (B) Residual right humeral shortening is 1.2 cm.
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F2
The external fixator was removed at postoperative 5.5 months with an overall length gain of 10 cm, resulting in a healing index of 0.55 month/cm (Fig. 2A). After four years of follow-up, both proximal humeral physes were closed, and the residual shortening of the right humerus was 1.2 cm (Fig. 2B).