Fracture of the humerus in ball throwers. A consequence of idiopathic juvenile osteoporosis in a female handball player?
We report a case of a spontaneous humeral shaft fracture sustained during pitching by a 22-year-old previously healthy female European team handball player. The fracture was treated by closed reposition followed by immobilization in a hanging cast. The fracture healed uneventfully, and normal function and range of motion were reached within 6 months. Between 1 and 2 years after the fracture, bone mineral measurements showed a decreased bone mass (1.43-2.56 SD below mean values of normal women) at all measuring sites; proximal tibia bilaterally (bone mineral content (right) = 2.68 g/cm, bone mineral content (left) = 2.79 g/cm), lumbar spine (bone mineral density (L2-4) = 0.814 g/cm2), and right hip (bone mineral density (neck) = 0.697 g/cm2, bone mineral density (Ward's) = 0.626 g/cm2). A thorough endocrinological examination indicated that a state of bone loss existed, but no specific endocrine disease was found. The unusual fracture presented must be considered the result of the torsional forces transmitted to a severely osteoporotic bone.
Landmark
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Department of Orthopaedic Surgery A, Frederiksberg Hospital, Denmark.
Petersen
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MM
D000328:Adult; D001265:Athletic Injuries / Q000097:blood / Q000209:etiology*; D015519:Bone Density; D005260:Female; D005596:Fractures, Closed / Q000097:blood / Q000209:etiology*; D005598:Fractures, Spontaneous / Q000097:blood / Q000209:etiology*; D006801:Humans; D006810:Humeral Fractures / Q000097:blood / Q000209:etiology*; D010024:Osteoporosis / Q000150:complications*