International Journal of Case Reports in Orthopaedics
2022, Vol. 4, Issue 1, Part B
Humeral shaft fractures in overhead throwing athletes: A case series
Author(s): Jonathan Boyce, Joshua Luginbuhl, Ryan Judy and Hesham Abdelfattah
Abstract: Humeral shaft fractures occurring in athletes exposed to repetitive overhead throwing are a rare but recognized phenomenon. Thrower’s fractures are most frequently seen in baseball but are also documented in other activities such as javelin and grenade throwing. There are many biomechanical studies and retrospective cohort studies supporting explanations for mechanism of injury but little data exists to support surgical intervention and post-operative functionality after the injury occurs.This case series examines the treatment and management of three baseball players who suffered thrower’s fractures. Three Caucasian recreational male athletes in their mid-20s presented with thrower’s fractures. None had prodromal symptoms. All were neurovascularly intact upon presentation and underwent open reduction internal fixation within 2 weeks of the injury. Follow-up time for each patient was variable but occurred as early as 3 weeks and as late as 3 months.Humeral shaft fractures from atraumatic overhead throwing can be considered rare stress fractures often preceded by prodromal pain. Radial nerve palsy is a potential complication of humeral shaft fractures. While the traditional treatment for humeral shaft fractures has been functional bracing, over the last decade surgical management has increased. Young, active patients with humeral fractures due to throwing related activities respond positively to early surgical intervention with plate fixation. Because the demographic of those with thrower’s fractures tends to be young, active males, we advocate for surgical fixation unless underlying medical conditions preclude the patient from surgery. This investigation supports recent literature promoting the operative fixation of not just humeral shaft fractures, but also thrower’s fractures. It is one of the largest examinations of thrower’s fractures to date.
Jonathan Boyce, Joshua Luginbuhl, Ryan Judy, Hesham Abdelfattah. Humeral shaft fractures in overhead throwing athletes: A case series. Int J Case Rep Orthop 2022;4(1):79-83. DOI: 10.22271/27078345.2022.v4.i1b.97
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