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Spontaneous fractures of the humerus during pitching

A series of 12 cases

Department of Orthopedic Surgery, Emory University, Atlanta, Georgia

Clyde Partin, EdD

Department of Physical Education, Emory University, Atlanta, Georgia

Patricia Chamberland, MD

Department of Orthopedic Surgery, Emory University, Atlanta, Georgia

Elizabeth Emeterio, ATC

Department of Physical Education, Emory University, Atlanta, Georgia

Michael Sabetelle, MS, ATC

Department of Physical Education, Emory University, Atlanta, Georgia

We report the recent occurrence of spontaneous hu meral shaft fractures in 12 pitchers. The subjects were interviewed over the telephone using a standard ques tionnaire. Radiographs and medical records were solic ited from their physicians. Their average age was 36 years and they had pitched an average of 11.4 years with an average layoff of 14 years (range, 7 to 24). Mean time between games pitched was 21 days (range, 3 to 56). The average number of pitches before the fracture occurred was 38 (range, 10 to 100). Pain was experienced at some point before the fracture in 75% of the pitchers and 75% of the fractures were spiral.

These fractures were most probably spontaneous fractures brought on by accumulated fatigue damage. The period of buildup after a prolonged period of layoff was probably insufficient time for proper bone remod eling to occur in these men. While a large percentage of these men had pain before their injury, suggesting a predisposing stress fracture, there is no doubt that their fractures could still be caused by a sudden torsional load without the presence of a stress fracture.

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