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Ulnar shaft stress fractures in fast-pitch softball pitchers: a case series and proposed mechanism of injury

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Abstract

Background

Stress fractures of the upper extremities in athletes are important injuries for radiologists to appreciate despite being far less common than stress fractures of the lower extremities. Among upper extremity stress fractures, those involving the olecranon have been well described in overhead pitching athletes. Isolated stress fractures of the ulnar shaft however are less commonly reported in the literature and considered to be rare. We have observed a correlation between young patients with ulnar shaft stress fractures and the activity of fast-pitch softball pitching.

Case Reports

In this series, we present the imaging findings in four cases of ulnar shaft stress fractures in softball pitchers who presented with insidious onset forearm pain. Furthermore, a review of the literature focusing on softball pitching mechanics is provided to offer a potential underlying mechanism for the occurrence and location of these injuries.

Conclusion

An awareness of the imaging appearance of ulnar shaft stress fractures along with an understanding of its proposed mechanism will facilitate accurate and timely imaging diagnosis of this injury by the radiologist.

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Authors and Affiliations

  1. Mayo Clinic Alix School of Medicine, 13400 East Shea Boulevard, Scottsdale, AZ, 85259, USA

    Jens T. Verhey

  2. College of Science, University of Notre Dame, 215 Jordan Hall of Science, Notre Dame, IN, 46556, USA

    Erik Verhey

  3. Baylor University Medical Center, 712 N. Washington Ave, Suite 101, Dallas, TX, 65212, USA

    David Holland

  4. Mallinckrodt Institute of Radiology, Washington University in St. Louis, 510 South Kingshighway Boulevard, St. Louis, MO, 63110, USA

    Jonathan C. Baker

  5. Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA

    Jeremiah R. Long

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  1. Jens T. Verhey
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  2. Erik Verhey
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  3. David Holland
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  4. Jonathan C. Baker
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  5. Jeremiah R. Long
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Correspondence to Jens T. Verhey.

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Verhey, J.T., Verhey, E., Holland, D. et al. Ulnar shaft stress fractures in fast-pitch softball pitchers: a case series and proposed mechanism of injury. Skeletal Radiol 50, 835–840 (2021). https://doi.org/10.1007/s00256-020-03624-4

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  • DOI: https://doi.org/10.1007/s00256-020-03624-4

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