Scaphoid Stress Fracture in Gymnastics Athlete: A Case Report

Nakamoto, João Carlos; Saito, Mateus; Cunha, Ana Paula; Luques, Isabela Ugo

doi:10.1016/s2255-4971(15)30154-3

Cited by 2 publications

(1 citation statement)

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“…It is believed that the second metacarpal has the highest force generated across it because it is the longest metacarpal and has the largest base 8 . Scaphoid stress fractures and distal radius epiphysiolysis have also been described and need to be considered in the differential diagnosis in patients presenting with pain about the radial wrist 9,10 . The patient's particular sport and activity level played a large role in sustaining a trapezoid stress fracture.…”

Section: Discussionmentioning

confidence: 99%

Trapezoid Stress Fracture in an Olympic-Level Gymnast

Bertha

Wisinski

Taylor

2023

JBJS Case Connector

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Case: A 23-year-old elite-level gymnast presented with insidious-onset pain near the base of the second metacarpal. The patient was found to have a trapezoid stress fracture and was treated nonoperatively in a thumb spica cast for 4 weeks. He resumed gymnastics without limitations 8 weeks from the time of diagnosis. Conclusion:Trapezoid stress fractures must be considered when evaluating patients presenting with pain about the base of the index finger metacarpal, particularly those who perform activities that repetitively place high loads across the wrist. Wrist immobilization and a supervised return to participation resulted in an excellent outcome for this patient. Fractures of carpal bones, other than the scaphoid, are uncommon. Fractures of the trapezoid represent less than 1% of all carpal fractures 1 . There are case reports of various carpal stress fractures resulting from athletics (Table I). Gymnasts are at a particularly high propensity for sustaining injuries in general 2 . Wrist injuries are particularly common in gymnastics due to the upper extremity weight-bearing that is experienced 3 . Although acute fractures of the trapezoid in athletes have been reported 1,4,5 , there has only been one description of a trapezoid stress fracture in a shotput athlete 6 . In this case report, we discuss a stress fracture of the trapezoid sustained in an Olympic-level gymnast who was treated nonsurgically with an excellent outcome. We also present a returnto-participation protocol.The patient was informed that data concerning the case would be submitted for publication, and he provided consent. Case ReportA 23-year-old Olympic-level male gymnast presented with the insidious onset of activity-related wrist pain over several weeks. He had recently increased the intensity and duration of his workouts in preparation for a major competition. Pain was most severe when weight-bearing on his hands while participating in various gymnastics disciplines. This was most significant with his primary event, the pommel horse. He had no symptoms at rest or with non2weight-bearing activities of daily living. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C52).

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Section: Discussionmentioning

confidence: 99%