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dc.contributor.authorLi, Xinning
dc.contributor.authorHeffernan, Michael J.
dc.contributor.authorMortimer, Errol S.
dc.date2022-08-11T08:10:07.000
dc.date.accessioned2022-08-23T16:56:21Z
dc.date.available2022-08-23T16:56:21Z
dc.date.issued2010-06-27
dc.date.submitted2012-03-07
dc.identifier.citationJ Pediatr Orthop. 2010 Jun;30(4):339-43. <a href="http://dx.doi.org/10.1097/BPO.0b013e3181dac0c1">Link to article on publisher's site</a>
dc.identifier.issn0271-6798 (Linking)
dc.identifier.doi10.1097/BPO.0b013e3181dac0c1
dc.identifier.pmid20502233
dc.identifier.urihttp://hdl.handle.net/20.500.14038/42913
dc.description.abstractLower 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20502233&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1097/BPO.0b013e3181dac0c1
dc.subjectAthletic Injuries
dc.subjectBaseball
dc.subjectCalcium
dc.subjectChild
dc.subjectFollow-Up Studies
dc.subjectFractures, Stress
dc.subjectHumans
dc.subjectHumeral Fractures
dc.subjectHyperparathyroidism, Secondary
dc.subjectMale
dc.subjectRecovery of Function
dc.subjectSpondylolysis
dc.subjectUlna Fractures
dc.subjectVitamin D
dc.subjectVitamin D Deficiency
dc.subjectOrthopedics
dc.subjectRehabilitation and Therapy
dc.titleUpper extremity stress fractures and spondylolysis in an adolescent baseball pitcher with an associated endocrine abnormality: a case report
dc.typeJournal Article
dc.source.journaltitleJournal of pediatric orthopedics
dc.source.volume30
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ortho_pp/111
dc.identifier.contextkey2643877
html.description.abstract<p>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.</p>
dc.identifier.submissionpathortho_pp/111
dc.contributor.departmentDepartment of Orthopedics and Physical Rehabilitation
dc.source.pages339-43


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