Stress fractures of the upper extremities in athletes (literature review)



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Background. Stress fractures of the upper extremities are a relatively rare pathology, typical for athletes. Due to their gradual onset, often unexpressed clinical symptoms and sometimes missing results during visualization, this pathology is often missed.

The aim is to present modern data on the pathogenesis, clinical picture, diagnosis, and treatment of stress fractures of the upper limbs in athletes.

Material and methods.  The search for publications was carried out in the PubMed/MEDLINE databases  and the Google from 1965 to 2020 using combinations of OR, AND operators and keywords: «stress fractures», «overuse fractures», «upper extremities», «athletes».  There were selected 76 sources (22 over the past 10 years).

Results. Stress fractures occur in about 40% of athletes, with 80-95% affecting the lower extremities and only 5-20% affecting the upper ones. The reason for their occurrence is the repetitive stress on the bones, which causes permanent microvascular injury, and is combined with overuse of the muscles surrounding the bone. The main diagnostic method for stress fractures is MRI. In most cases, bone recovery when the load is limited and the athlete's activity is modified (eliminating repetitive movements that cause injury). Surgical treatment is often required for stage III “gymnast's wrist”, detached fractures of the medial epicondyle with a displacement of at least 10 mm, complete or partial ruptures of the ulnar collateral ligament of the elbow joint, fractures of the ulnar process, wrist bones.

Conclusion. Despite the low frequency of occurrence, stress fractures of the upper extremities can create significant problems for athletes and their professional growth. A careful clinical history collection,  examination, and analysis of the possible mechanism of injury allow to suspect this pathology. Restriction the  physical activity, eliminating the provocative factors, gradually increasing the intensity of training, as well as improving sports equipment, make it possible in most cases for the patient to avoid surgical treatment and return to sports.

Keywords: stress fractures, overuse fractures, upper extremities, athletes.

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Olga Agranovich

H.Turner National Medical Research Center for Сhildren's Orthopedics and Trauma Surgery, Saint-Petersburg

编辑信件的主要联系方式.
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
http://www.rosturner.ru/kl10.htm

MD, PhD, D.Sc., head of the department of arthrogryposis;

member of the Paediatric Hand International Society Of Surgeons (PHISOS); Federation of European Societies for Surgery of the Hand (FESSH); The International study group on arthrogryposis.

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  • Address: Russia, 64-68 Park Street, St. Petersburg, Pushkin, 196603
  • Email: olga_agranovich@yahoo.com
  • Phone: +7 (812) 318-5419

 

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