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Speciality Spotlight
Fractures
Humeral Fracture
- Ogawa K Yoshida (Keio
Univ, Tokyo)
Throwing Fracture of the Humeral Shaft: An Analysis of 90 Patients.
Am J Sports Med 26: 242-246, 1998.
The authors have published possibly the largest series of this entity. These fractures occur most frequently during pitching. 91% occurred during overhand or three quarters overhand throwing. There was no evidence of stress fracture earlier. The fractures are spiral, and occur below the insertion of deltoid at the junction of middle and lower 1/3rd of humerus. There was no comminution. 14 patients had associated radial palsy, which recovered spontaneously. The main fracture force is an external rotation occurring during the acceleration phase of the throw. Patients who practice irregularly are at greater risk
Stress Fractures
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Brukner P (Olympic Park Sports Medicine Centre, Melbourne, Australia)
Stress Fractures of the Upper Limb
Sports Med 26: 415-424, 1998.
Stress fractures of the upper limb are rare and occur mainly in upper limbs dominated sports.
Gradual onset bone pain and tenderness are the prominent findings. Such fractures have been seen in the clavicle, scapula, humerus, olecranon, ulna, radius and metacarpal.
The diagnosis may be confirmed by a radiograph but an isotope scan is more diagnostic.
The majority of patients recover after a few weeks of rest and rehabilitation helps them to return to active sports.