Brachial Plexus Palsy Secondary to Stress Fracture of the First Rib

Bilateral first rib stress fractures in a female swimmer: a case report

“…4,10,20,21 The patient may also have neurologic symptoms, which include pain or numbness radiating to the sternum, pectoral region, or down the arm. 19,22 In general, shoulder pain in swimmers is most commonly related to fatigue that results from overuse and dysfunction of the rotator cuff and periscapular muscles and can alter shoulder kinematics and cause secondary impingement. Capsular laxity and resultant shoulder instability may also play a role in shoulder pain in swimmers.…”

“…Partial or complete resection of the rib can be considered in the setting of brachial plexus palsy secondary to excessive callus formation. 22,24,28 Other potential complications of rib fractures include Horner syndrome and thoracic outlet syndrome. 7,22,28 Regardless of initial treatment, a careful rehabilitation program and analysis of mechanics are important to prevent reinjury.…”

“…Repetitive stresses in athletes can result in accelerated bone remodeling that overwhelms bony healing and, ultimately, causes stress fractures. 14 Although uncommon, stress fractures of the rib have been reported in association with a number of sports, including rowing, 9 basketball, 19 baseball, 21 volleyball, 22 football, 3 soccer, 20 squash, 23 tennis, 4,15 lacrosse, 19 kickboxing, 27 gymnastics, 24 golf, 17 swimming, 29 weightlifting, 11 aerobics, 15 ballet, 6 and canoeing. 18 There has only been one previous report of a swimmer with a unilateral rib stress fracture, to our knowledge.…”

First Rib Stress Fractures in Throwing Athletes

“…[2][3][4][5]12,20 Theorized mechanisms of a stress fracture of the first rib consist of the following: (1) external trauma, (2) violent contraction of the muscles attached to the rib, and (3) stress-induced fatigue secondary to repetitive muscle traction. 5,20,21,24 Although the first mechanism is most common in the general population, 26 in the 3 most recent cases reported in baseball, the mechanism of fracture was the secondary fatigue thought to be caused by repetitive muscle contraction.…”

First Rib Fracture of Unknown Etiology: A Case Report

“…15 -33 Symptoms resulting from fractures without an obvious history of trauma can commonly be overlooked and diagnosed as a muscle strain or joint sprain. 27,32 Although rare, first rib fractures should be included in the differential diagnosis of patients who present with scapular, upper thoracic, and/or sternal pain. We present a patient complaining of medial scapula, upper thoracic, and sternal pain who was subsequently found to have a fracture of the first rib.…”