Scaphoid Stress Fracture in High-Level Gymnast: A Case Report

J C Nakamoto,M Saito,G Medina,B Schor

doi:10.1155/2011/492407

Abstract

We present the case of an 18-year-old high-level gymnast who sustained a stress fracture of the scaphoid associated with a distal radial epiphysiolysis. Clinical evaluation demonstrated decreased range of motion of the affected wrist and insidious pain on the snuffbox and tenderness on the distal radial physis. He was submitted to surgical treatment with scaphoid percutaneous fixation and radial styloid process in situ fixation. Clinical features improved, and he got back to competition 6 months after surgery without symptoms and with complete range of motion.

Highlights

Lower extremity stress fractures are common and are usually related to overtraining
Chronic repetitive dorsiflexion with axial compression of the wrist are frequently associated with injuries of the distal radial growth plate. This injury is typically seen on radiographs as a widened and irregular distal radius physis [6, 7]
We present the case of a gymnast who sustained a stress fracture of the scaphoid associated with a distal radial epiphysiolysis

Summary

Introduction

Lower extremity stress fractures are common and are usually related to overtraining. this kind of injury is rare in the upper limbs and there are few reports in the literature regarding this trauma [1]. Patients who perform activities with repetitive stress on the wrist and present similar complaints, without a history of acute trauma, should be thoroughly investigated and one should suspect of a scaphoid stress fracture [4, 5]. Chronic repetitive dorsiflexion with axial compression of the wrist are frequently associated with injuries of the distal radial growth plate. This injury is typically seen on radiographs as a widened and irregular distal radius physis [6, 7]. On physical examination the patient had soft callus over the distal wrist and the right scaphoid He reported pain in the anatomic snuffbox and in distal radial epiphysis. A magnetic resonance imaging (MRI) examination of the wrist was performed and revealed an incomplete fracture at

Parameter Extension Flexion Radial deviation Ulnar deviation Grip strength

Findings

Discussion