M89.123

Clinical Causes: Trauma or fractures involving the proximal humeral growth plate Infections affecting the growth plate Radiation therapy near the shoulder region Congenital abnormalities or genetic conditions Previous surgical procedures involving the shoulder Repetitive stress or microtrauma to the shoulder joint

Key Symptoms: Discrepancy in arm length compared to the unaffected side Deformity or angulation of the upper arm Limited range of motion in the shoulder joint Pain or tenderness in the shoulder area Weakness or decreased strength in the affected arm Visible swelling or tenderness over the shoulder

Diagnosis Path: Diagnosis typically involves a combination of clinical examination and imaging studies. Initial assessment may include a detailed medical history and physical examination focusing on arm length, deformity, and shoulder function. Imaging techniques such as X-rays are crucial in visualizing the growth plate, detecting areas of arrest, and assessing deformity. In some cases, MRI scans may be used to evaluate the soft tissues and the status of the growth plate in greater detail. Bone scans can also assist in identifying areas of decreased growth activity.

Treatment Protocols: Management of partial physeal arrest depends on the extent of deformity and functional impairment. Common approaches include: - Conservative treatment such as physical therapy to maintain range of motion and strengthen surrounding muscles. - Observation in cases where the deformity is minimal and does not interfere with function. - Surgical interventions, which may include: - Corrective osteotomy to realign the bone - Bone grafting procedures to restore length or correct deformity - Growth modulation techniques to encourage growth in the affected area - Epiphysiodesis or other procedures to slow growth on the unaffected side if asymmetry is significant. Early diagnosis and treatment planning are essential to improving outcomes and preventing long-term disability.