Upper limb length discrepancy is a rare occurrence. Humerus shortening may need specialized treatment to restore the functional and cosmetic status of upper limb. We report a case of humerus lengthening of 9 cm with a monorail external fixator and the result was observed during a 2-year follow-up. Humerus lengthening needs specialized focus as it is not only a cosmetic issue but also a functional demand. The monorail unilateral fixator is more functional and cosmetically acceptable, and thus becomes an effective treatment option.
Adult ; Bone Lengthening ; instrumentation ; External Fixators ; Female ; Humans ; Humerus ; physiology ; surgery ; Range of Motion, Articular ; Surgery, Plastic ; instrumentation

The PE_PGRS family of proteins unique to mycobacteria is demonstrated to contain multiple calcium-binding and glycine-rich sequence motifs GGXGXD/NXUX. This sequence repeat constitutes a calcium-binding parallel beta-roll or parallel beta-helix structure and is found in RTX toxins secreted by many Gram-negative bacteria. It is predicted that the highly homologous PE PGRS proteins containing multiple copies of the nona-peptide motif could fold into similar calcium-binding structures. The implication of the predicted calcium-binding property of PE PGRS proteins in the light of macrophage-pathogen interaction and pathogenesis is presented.
Amino Acid Motifs ; Amino Acid Sequence ; Antigens, Bacterial ; chemistry ; genetics ; metabolism ; Bacterial Proteins ; chemistry ; genetics ; metabolism ; Base Sequence ; Binding Sites ; genetics ; Calcium ; metabolism ; DNA, Bacterial ; genetics ; Membrane Proteins ; chemistry ; genetics ; metabolism ; Models, Molecular ; Molecular Sequence Data ; Mycobacterium tuberculosis ; genetics ; metabolism ; Protein Structure, Secondary

Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure.
Adult ; Female ; Humans ; Humeral Fractures ; surgery ; Postoperative Complications ; Radial Neuropathy ; etiology