Spontaneous fractures of the humerus during pitching

Abstract

We report the recent occurrence of spontaneous humeral shaft fractures in 12 pitchers. The subjects were interviewed over the telephone using a standard questionnaire. Radiographs and medical records were solicited from their physicians. Their average age was 36 years and they had pitched an average of 11.4 years with an average layoff of 14 years (range, 7 to 24). Mean time between games pitched was 21 days (range, 3 to 56). The average number of pitches before the fracture occurred was 38 (range, 10 to 100). Pain was experienced at some point before the fracture in 75% of the pitchers and 75% of the fractures were spiral. These fractures were most probably spontaneous fractures brought on by accumulated fatigue damage. The period of buildup after a prolonged period of layoff was probably insufficient time for proper bone remodeling to occur in these men. While a large percentage of these men had pain before their injury, suggesting a predisposing stress fracture, there is no doubt that their fractures could still be caused by a sudden torsional load without the presence of a stress fracture.

Surgical result of plate osteosynthesis using a locking plate system through an anterior humeral approach for distal shaft fracture of the humerus that occurred during a throwing motion

“…However, indirect force involving throwing or arm wrestling can also induce fracture. Humeral shaft fractures occurring secondary to throwing motion are called "throwing fractures" in the literature [1][2][3]. This type of fracture usually presents as a spiral fracture of middistal shaft of the humerus [1].…”

Acute subscapularis tendon rupture caused by throwing: A case report

“…Past reports suggest that age greater than 30 years, a prolonged period of abstention from sports activity, lack of technical expertise, fatigue, failure to perform warm-up exercise, and ingestion of alcohol are involved in the pathomechanism of these injuries, which may interrupt the muscular outputregulating mechanism, causing disorders. 2,4,10,14 In this case, we speculate that a lack of recent proper training and drinking alcohol immediately before the game were important factors.…”

Case Report: Longitudinal Stress Fracture of the Humerus: Imaging Features and Pitfalls

“…Humeral stress fractures have been described in tennis players [21], baseball pitchers [2,6], badminton players [5], volleyball players, weight lifters [13,18], and arm wrestlers [15]. Humeral stress fractures also have been reported in military personnel active in grenade throwing [14].…”

“…Humeral stress fractures also have been reported in military personnel active in grenade throwing [14]. When present, humeral stress fractures are usually complete spiral fractures of the middle to distal shaft [2,6,14,15,18]. Stress reaction without fracture also has been reported involving the humerus [21].…”