Q: My six years old son developed septic arthritis in his right shoulder just nine days after his birth. A surgery was done to treat the infection after 13 days of birth. Though he can move his arm well, his right hand looks shorter than his left hand. The doctor told us due to damaged shoulder, the bone connecting the shoulder to the right hand is not growing. Please advise.

A:When there is infection in the shoulder joint at such a young age, the growth plate of the arm gets affected. This is a common problem in patients with septic arthritis of the shoulder. The Humerus, which is the bone of the arm, grows from the two ends of the bone, the shoulder side and the elbow side. Most of the growth of the arm occurs from the shoulder side. Therefore, any pathology that affects the growth potential of the growth plate (like an infection) will affect the growth of the arm. There is nothing that you can do to change the damage that has occurred. However, you could keep the difference in growth under observation as the final level of shortening will depend on the extent and the severity of the damage.

Techniques are now available to lengthen short limb segments in this case the arm. However, in the upper limb function of the hand is far more important than the length of the arm. If the difference is not too much, nobody would notice it also unless you tell them. The dictum we follow for the upper limb is function is far more important than form. Therefore, I would recommend that you follow your doctor’s advice to keep this under observation only and monitor the difference in length with the increase in the height of the child.