Case Report : Multiple Stress Fractures (hamate, triquetrum, 2nd, 3rd, and 4th Metacarpal bones) in an Amateur Tennis Player

##plugins.themes.bootstrap3.article.main##

  •   Hatim Mohammed A. AlShareef

  •   Alhusain Mohammad Alshareef

  •   Mohammed Hussein AlKaff

Abstract

Background: upper extremity stress fractures are infrequent events in tennis sport. According to our literature, we have only identified 6 case reports of upper limb stress fractures among amateur or professional tennis players. To the best of our knowledge, this is the only case report where stress fractures occur in: hamate, triquetrum, 2nd, 4th, and 5th metacarpal bones simultaneously.


Case presentation: 27 years old lady, presented with acute burning pain at the base of her right thumb. There was not a history of direct trauma. Her symptoms start to appear after 3 days of playing tennis. Physical examination was negative for tenderness, swelling and erythema. The rheumatoid factor was elevated (20.3 iu/ml). the diagnosis of multiple stress fractures was made by the suggestive MRI findings.


Conclusion: Although stress fractures of the upper limbs are not common, it is of a great value to keep the clinical suspicion high towards it. Especially in amateur or professional athletes with persistent or worsening symptoms. The best modality to confirm such fractures is MRI.


Keywords: Stress fractures, upper limb, upper extremity, tennis.

References

Arendt E, Agel J, Heikes C, Griffiths H. Stress injuries to bone in college athletes: a retrospective review of experience at a single institution. The American journal of sports medicine. 2003 Jun;31(6):959-68.

Jones GL. Upper extremity stress fractures. Clinics in sports medicine. 2006 Jan 1;25(1):159-74.

Matheson GO, Clement DB, McKenzie DC, Taunton JE, Lloyd-Smith DR, MacIntyre JG. Scintigraphic uptake of 99m Tc at non-painful sites in atheles with stress fractures: the concept of bone strain. Sports Med. 1987;4:65-75.

Matheson GO, Clement DB, McKenzie DC, Taunton JE, Lloyd-Smith DR, Macintyre JC. Stress fractures in athletes: a study of 320 cases. Am J Sports Med. 1987;15:46-58.

Roca J, Cabot J. Fracturas por sobrecarga en el deportista: apunts. Medicina de l’esport. 1985;22:17-28.

Balius R, Pedret C, Estruch A, Hernández G, Ruiz-Cotorro Á, Mota J. Stress fractures of the metacarpal bones in adolescent tennis players: a case series. The American journal of sports medicine. 2010 Jun;38(6):1215-20.

Maquirriain J, Ghisi JP. The incidence and distribution of stress fractures in elite tennis players. British journal of sports medicine. 2006 May 1;40(5):454-9.

Duarte ML, da Nóbrega RR, de Almeida Prado JL, Scoppetta LC. Metacarpal stress fracture in amateur tennis player–an uncommon fracture. Revista Brasileira de Ortopedia (English Edition). 2017 Sep 1;52(5):608-11.

Muramatsu K, Kuriyama R. Stress fracture at the base of second metacarpal in a soft tennis player. Clinical Journal of Sport Medicine. 2005 Jul 1;15(4):279-80.

Bespalchuk A, Okada K, Nishida J, Takahashi S, Shimada Y, Itoi E. Stress fracture of the second metacarpal bone. Skeletal radiology. 2004 Sep 1;33(9):537-40.

Kohyama S, Kanamori A, Tanaka T, Hara Y, Yamazaki M. Stress fracture of the scaphoid in an elite junior tennis player: a case report and review of the literature. Journal of medical case reports. 2016 Dec;10(1):8.

Josipovic M, Bozic D, Bohacek I, Smoljanovic T, Bojanic I. Hamate hook nonunion initially mistaken for ulnar nerve compression: a case report with review of literature. Wiener klinische Wochenschrift. 2017 Feb 1;129(3-4):136-40.

Guha AR, Marynissen H. Stress fracture of the hook of the hamate. British journal of sports medicine. 2002 Jun 1;36(3):224-5.

Waninger KN, Lombardo JA. Stress fracture of index metacarpal in an adolescent tennis player. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine. 1995;5(1):63-6.

Muramatsu K, Kuriyama R. Stress fracture at the base of second metacarpal in a soft tennis player. Clinical Journal of Sport Medicine. 2005 Jul 1;15(4):279-80.

Nampei A, Hashimoto J, Koyanagi J, Ono T, Hashimoto H, Tsumaki N, Tomita T, Sugamoto K, Nishimoto N, Ochi T, Yoshikawa H. Characteristics of fracture and related factors in patients with rheumatoid arthritis. Modern rheumatology. 2008 Apr 1;18(2):170-6.

Shmerling RH, Delbanco TL. The rheumatoid factor: an analysis of clinical utility. The American journal of medicine. 1991 Nov 1;91(5):528-34.

Downloads

Download data is not yet available.

##plugins.themes.bootstrap3.article.details##

How to Cite
AlShareef, H. M., Alshareef, A., & AlKaff, M. (2020). Case Report : Multiple Stress Fractures (hamate, triquetrum, 2nd, 3rd, and 4th Metacarpal bones) in an Amateur Tennis Player. European Journal of Medical and Health Sciences, 2(3). https://doi.org/10.24018/ejmed.2020.2.3.274