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Review
. 2024 Sep 26;10(1):100.
doi: 10.1186/s40798-024-00769-7.

Upper Extremity Stress Fractures

Ezekial J Koslosky  1   2 , David M Heath  1   2 , Cameron L Atkison  3   4 , Anil Dutta  1   2 , Christina I Brady  1   2
Affiliations
Review

Upper Extremity Stress Fractures

Ezekial J Koslosky et al. Sports Med Open. .

Abstract

Background: Stress injuries are often missed secondary to their insidious onset, milder symptoms, and subtle or initially absent findings when imaged.

Main body: This review aims to provide strategies for evaluating and treating upper extremity stress fractures. This article outlines the classic presentation of each fracture, the ages during which these injuries often occur, the relevant anatomy and biomechanics, and the mechanism of each injury. Diagnostic imaging and management principles are also discussed, including the use of conservative versus surgical management techniques.

Short conclusion: Upper extremity stress fractures are often mild injuries that resolve with conservative management but can lead to more serious consequences if ignored. Given their increasing incidence, familiarity with diagnosis and management of these injuries is becoming increasingly pertinent.

Keywords: Clavicle; Humerus; Ribs; Scapula; Stress fracture; Ulna.

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Conflict of interest statement

The authors do not have any competing interests to declare.

Figures

Fig. 1
Fig. 1
Zanca view demonstrating medial clavicle stress fracture in an adolescent weightlifter. Reproduced from Kang et al. [46], with permission
Fig. 2
Fig. 2
Clavicle X-rays. Top: cystic erosions noted at distal clavicle (arrows). Middle: six months later demonstrating decreased acromioclavicular joint space and reorganization of distal clavicle (arrows). Bottom: One year after initial visit, showing normal distal clavicle. Reproduced from Mestan et al. [47], with permission
Fig. 3
Fig. 3
Little League shoulder. Anterior-posterior radiographs of bilateral proximal humeri of the same patient demonstrating widening of the proximal humeral physis on the right as compared with the normal left side. Reproduced from Stanley et al. [48], with permission
Fig. 4
Fig. 4
Little League elbow. T2 magnetic resonance image (MRI) demonstrating increased signal intensity at the medial epicondyle apophysis. Reproduced from Kajiwara et al. [49], with permission
Fig. 5
Fig. 5
Magnetic resonance image (MRI) demonstrating olecranon stress fracture. Reproduced from Greif et al. [39], with permission
Fig. 6
Fig. 6
Ulnar stress fracture. (Left) Lateral radiograph of a left forearm showing cortical thickening along the volar cortex; (Right) Sagittal inversion recovery image of a forearm demonstrating periosteal, cortical and medullary edema (arrowheads) along the volar aspect of the ulnar diaphysis as well as a subtle oblique low signal fracture line (arrow). Reproduced from Dean et al. [51], with permission
See this image and copyright information in PMC

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