Computer simulation of humeral shaft fracture in throwing.
OBJECTIVE
Throwing fractures of the humerus are well known, but the exact mechanism of injury is not clear. It has been postulated that these may be stress fractures because the forces have not seemed sufficient to cause acute fractures while throwing.


METHODS
Using finite element analysis, we reproduced fractures of the humerus using 3-dimensional models built from computed tomography images of 5 healthy volunteers. To apply the load during throwing, we assumed that the humeral head was completely fixed, and external rotation torque was applied to the distal end of the humerus until the stress of the bone elements became greater than yield stress. We reproduced the fracture line by removing the bone elements.


RESULTS
The maximum stress concentration was seen in the distal shaft, where a typical spiral fracture was created in all cases. In the humeral models, the torque required to initiate fracture ranged from 51 to 70 Nm. A strong correlation existed between the torque required to initiate fracture and thickness of the humeral cortical bone (R(2) = 0.74).


CONCLUSIONS
These results indicate that thickness of the humerus represents one factor contributing to fractures that occur while throwing.


METHODS
Basic science study.
Sakai
Kensuke
K
Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan.
Kiriyama
Yoshimori
Y
Kimura
Hiroo
H
Nakamichi
Noriaki
N
Nakamura
Toshiyasu
T
Ikegami
Hiroyasu
H
Matsumoto
Hideo
H
Toyama
Yoshiaki
Y
Nagura
Takeo
T
D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D013314:Stress, Mechanical; D013718:Tensile Strength; D014057:Tomography, X-Ray Computed; D019415:Torque; D055815:Young Adult