Upper extremity stress fractures and spondylolysis in an adolescent baseball pitcher with an associated endocrine abnormality: a case report
UMass Chan Affiliations
Department of Orthopedics and Physical RehabilitationDocument Type
Journal ArticlePublication Date
2010-06-27Keywords
Athletic InjuriesBaseball
Calcium
Child
Follow-Up Studies
Fractures, Stress
Humans
Humeral Fractures
Hyperparathyroidism, Secondary
Male
Recovery of Function
Spondylolysis
Ulna Fractures
Vitamin D
Vitamin D Deficiency
Orthopedics
Rehabilitation and Therapy
Metadata
Show full item recordAbstract
Lower extremity stress fractures are relatively common among competitive athletes. Stress fractures of the upper extremity, however, are rare and most have been reported in the literature as case reports. We present a case of an adolescent baseball pitcher who had both proximal humeral and ulnar shaft stress fractures, as well as spondylolysis of the lumbar spine. This particular patient also had an underlying endocrine abnormality of secondary hyperparathyroidism with a deficiency in vitamin D. A bone mineral density panel demonstrated a high T score (+2.79 SD above the mean) and the patient's biologic bone age was noted to be 2 years ahead of his chronologic age. The patient was treated with a course of vitamin D and calcium supplementation. After treatment, both the vitamin D and parathyroid hormone returned to normal levels. The upper extremity stress fractures and spondylolysis were managed conservatively and he was able to return to full activity and baseball. For patients who present with multiple stress fractures not associated with consistent high levels of repeated stress, a bone mineral density panel should be considered. If vitamin D deficiency is present, a course of oral supplementation may be considered in the management. An endocrinology consult should also be considered in patients who present with multiple stress fractures. Conservative management of upper extremity stress fractures and spondylolysis was successful in returning this patient back to his previous activity level.Source
J Pediatr Orthop. 2010 Jun;30(4):339-43. Link to article on publisher's siteDOI
10.1097/BPO.0b013e3181dac0c1Permanent Link to this Item
http://hdl.handle.net/20.500.14038/42913PubMed ID
20502233Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/BPO.0b013e3181dac0c1