title: Proximal ulna stress fracture and stress reaction of the proximal radius associated with the use of crutches: a case report and literature review.
abstract: We report a case of complete stress fracture of the ulna and stress reaction of the radius resulting from the use of crutches in an overweight patient with severe lower extremity arthritis. Plain radiograph showed an undisplaced complete fracture of the proximal metaphysis of the ulna. Magnetic resonance imaging (MRI) was performed to exclude a pathological cause in view of the unusual fracture site, which confirmed the plain radiographic findings and additionally demonstrated a stress reaction in the proximal radius. There are three cases of stress fracture of the ulnar diaphysis resulting from the use of crutches reported previously in the English literature and a further case of bilaterally symmetrical ulnar diaphysial fracture reported in the Danish literature. We report the first case of ulnar metaphysis stress fracture with concomitant stress reaction of the radius.
authors.affiliation: Department of Radiology, Peninsula Radiology Academy, Derriford Hospital, Plymouth International Business Park, Plymouth, UK. nandashettykv@yahoo.com
authors.forename: Nanda
authors.initials: N
authors.lastname: Venkatanarasimha
authors.forename: Sridhar
authors.initials: S
authors.lastname: Kamath
authors.forename: G
authors.initials: G
authors.lastname: Kambouroglou
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Ostlere
mesh_terms: D003446:Crutches / Q000009:adverse effects*; D005260:Female; D015775:Fractures, Stress / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011884:Radius / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology*; D013312:Stress, Physiological; D014057:Tomography, X-Ray Computed; D014458:Ulna Fractures / Q000175:diagnosis / Q000209:etiology*
references.citation: Am J Sports Med. 1983 Mar-Apr;11(2):103-6
references.pmid: 6846680
references.citation: Clin Sports Med. 2006 Jan;25(1):159-74, xi
references.pmid: 16324982
references.citation: Ugeskr Laeger. 1992 Jun 22;154(26):1850-1
references.pmid: 1509542
references.citation: Skeletal Radiol. 2003 Jan;32(1):22-7
references.pmid: 12525940
references.citation: J Orthop Trauma. 2001 Sep-Oct;15(7):524-5
references.pmid: 11602837
references.citation: Br J Sports Med. 1998 Dec;32(4):340-2
references.pmid: 9865410
references.citation: Clin J Sport Med. 1999 Oct;9(4):231-2
references.pmid: 10593219
references.citation: Am J Sports Med. 1984 Sep-Oct;12(5):405-6
references.pmid: 6496840
references.citation: Skeletal Radiol. 2004 Sep;33(9):541-4
references.pmid: 15205926
references.citation: Injury. 1988 Sep;19(5):360-1
references.pmid: 3255720
references.citation: Am J Sports Med. 2002 Jan-Feb;30(1):130-2
references.pmid: 11799010