What is your diagnosis? Metaphyseal osteopathy.
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In a new surgical approach to the proximal part of the humerus, used in eighteen patients, the distal part of the tendon of the deltoid muscle was divided and the whole muscle was lifted up to give an excellent view of the proximal one-third of the diaphysis, the metaphysis, the surgical neck, and both tuberosities of the humerus. The exposure allowed visualization and protection of the axillary nerve. Postoperatively the deltoid remained functional and only the preoperative condition of the joint seemed to prevent full recovery of function of the muscles in a few patients.
A new dwarfism of a spondyloepiphysometaphyseal dysplasia is described among Venezuelan Indians of the Yukpa (Irapa) tribe. Brachyrrhahia, brachymetatarsia and brachyrhyzomelia in upper limbs and manifestations in proximal epiphyses of femora and distal epiphyses of humera, with moderate to serious impairment of gait, but no significance deviations of the spine, are the main clinical findings. It is a well individualized type among a very heterogeneous and ill-defined group of chondrodystrophies. The inheritance is through an autosomal recessive or less probably an X-linked gene.
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