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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(01): 175-179
DOI: 10.1055/s-0040-1721837
Relatos de Casos
Artroscopia e Traumatologia do Esporte

Humerus Diaphyseal Stress Fracture in a Teenage Tennis Athlete: Case Report

Article in several languages: português | English
Márcio Schiefer 
1   Departamento de Ortopedia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
5   Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil
,
Francisco Nanci 
2   Hospital Central da Polícia Militar, Rio de Janeiro, RJ, Brasil
,
Luiz Eduardo Abílio 
3   Estagiário de Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil
,
Yonder Archanjo Ching San Junior 
4   Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
,
Geraldo Motta Filho 
5   Centro de Cirurgia do Ombro e Cotovelo, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil
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Abstract

A teenage male tennis player had chronic pain in his dominant arm during tennis practice. Magnetic resonance imaging (MRI) suggested humerus diaphyseal stress injury. After 4 weeks, he became asymptomatic and resumed playing. However, pain recurred after 3 days. A new MRI revealed a diaphyseal undisplaced humerus fracture and significant bone marrow edema. The patient remained in rest for 4 weeks. After that, strengthening exercises were introduced and return to training was allowed after 12 weeks. Even if asymptomatic, we suggest that these patients should not return to play before 12 weeks, depending on the physical exam and imaging findings.

Keywords

fractures, stress - humeral fractures - humerus - tennis/injuries

Financial Support

There was no financial support from public, commercial, or not-for-profit sources.


The present work was performed at the National Institute of Traumatology and Orthopedics (INTO).




Publication History

Received: 03 June 2020

Accepted: 17 September 2020

Article published online:
19 April 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • Referências

  • 1 Smith SR, Patel NK, White AE, Hadley CJ, Dodson CC. Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review. Orthop J Sports Med 2018; 6 (10) 2325967118799262
    CrossrefPubMedGoogle Scholar
  • 2 Anderson MW. Imaging of upper extremity stress fractures in the athlete. Clin Sports Med 2006; 25 (03) 489-504
    CrossrefPubMedGoogle Scholar
  • 3 Maquirriain J, Ghisi JP. The incidence and distribution of stress fractures in elite tennis players. Br J Sports Med 2006; 40 (05) 454-459
    CrossrefPubMedGoogle Scholar
  • 4 Rizzone KH, Ackerman KE, Roos KG, Dompier TP, Kerr ZY. The epidemiology of stress fractures in collegiate student-athletes, 2004–2005 through 2013–2014 academic years. J Athl Train 2017; 52 (10) 966-975
    CrossrefPubMedGoogle Scholar
  • 5 Changstrom BG, Brou L, Khodaee M, Braund C, Comstock RD. Epidemiology of stress fracture injuries among US high school athletes, 2005-2006 through 2012-2013. Am J Sports Med 2015; 43 (01) 26-33
    CrossrefPubMedGoogle Scholar
  • 6 Gregory P. Upper extremity injuries in the athlete. J Orthop Trauma 1995; 9 (04) 361
    CrossrefGoogle Scholar
  • 7 Jones GL. Upper extremity stress fractures. Clin Sports Med 2006; 25 (01) 159-174 , xi
    CrossrefPubMedGoogle Scholar
  • 8 Iwamoto J, Takeda T. Stress fractures in athletes: review of 196 cases. J Orthop Sci 2003; 8 (03) 273-278
    CrossrefPubMedGoogle Scholar
  • 9 Milgrom C, Finestone A, Shlamkovitch N. et al. Youth is a risk factor for stress fracture. A study of 783 infantry recruits. J Bone Joint Surg Br 1994; 76 (01) 20-22
    CrossrefPubMedGoogle Scholar
  • 10 Hoy G, Wood T, Phillips N, Connell D, Hughes DC. When physiology becomes pathology: the role of magnetic resonance imaging in evaluating bone marrow oedema in the humerus in elite tennis players with an upper limb pain syndrome. Br J Sports Med 2006; 40 (08) 710-713 , discussion 713
    CrossrefPubMedGoogle Scholar