Humerus shaft fracture caused by arm wrestling injury: examination of mechanism through radiological analysis
Chi-Hoon Oh, Jaiwoo Chung, Cheungsoo Ha, Soo-Hong Han
Department of Orthopedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam, Korea
Correspondence to: Soo-Hong Han, https://orcid.org/0000-0002-8951-650X
Department of Orthopedic Surgery, CHA Bundang Medical Center, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-5289, Fax: +82-31-708-3578, E-mail: hsoohong@cha.ac.kr
Department of Orthopedic Surgery, CHA Bundang Medical Center, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-5289, Fax: +82-31-708-3578, E-mail: hsoohong@cha.ac.kr
Received December 30, 2023; Revised April 4, 2024; Accepted April 10, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Abstract
- Background: Arm wrestling, a widely practiced sport, particularly among young male, has been associated with humerus shaft fractures. This study analyzed the occurrence patterns of humerus fractures and patients’ characteristics during arm wrestling exercises, considering radiological results and injury mechanisms.
Methods: This was a retrospective analysis of 20 humeral fractures resulting from arm wrestling injuries. Surgical treatment using dual plates was performed in all cases, and radiographic imaging data were analyzed to determine fracture location, AO classification, and injury mechanisms. Cases with radial nerve palsy and bone healing period were also evaluated.
Results: All participants were male, with an average age of 27 years, and most fractures occurred on the right side. Fractures were predominantly AO type A1 (40.0%) and B2 (60.0%). Arm positions at the time of fracture varied, with external rotation being the most common (50.0%). All fractures successfully united with an average healing time of 14 weeks, and two cases with radial nerve palsy recovered completely. Spiral fractures were predominant, with consistent characteristics observed in 3-dimensional computed tomography reconstruction. All fracture patterns exhibited an oblique fracture slope angle, which suggested that the injuries were primarily caused by rotational forces, even in AO type B2 fractures. Results suggest a progression from A1 to B2 fractures driven by compression force. Fractures occurred more frequently in losing or neck-and-neck situations, emphasizing the importance of creating winning conditions to prevent injuries.
Conclusion: Most fractures occurred in nonarm wrestling experts, often in losing situations. Despite its global popularity, more fractures occur among nonprofessionals. Such injuries may be prevented by determining the winner or loser before entire external arm rotation. Alternatively, promoting arm wrestling among those with professional training is advised. - Keywords : Arm wrestling; Humeral fractures; Dual plate; Radial neuropathy
- References
- Kim KE, Kim EJ, Park J, Kim SW, Kwon J, Moon G. Humeral shaft fracture and radial nerve palsy in Korean soldiers: focus on arm wrestling related injury. BMJ Mil Health 2021;167:80-3.
- Moloney DP, Feeley I, Hughes AJ, Merghani K, Sheehan E, Kennedy M. Injuries associated with arm wrestling: a narrative review. J Clin Orthop Trauma 2021;18:30-7.
- Mayfield CK, Egol KA. Humeral fractures sustained during arm wrestling: a retrospective cohort analysis and review of the literature. Orthopedics 2018;41:e207-10.
- Khashaba A. Broken arm wrestler. Br J Sports Med 2000;34:461-2.
- Bumbaširević MŽ, Lešić AR, Andjelković SZ, Palibrk TD, Milutinović SM. Fractures of the humerus during arm wrestling. Vojnosanit Pregl 2014;71:1144-6.
- Ogawa K, Ui M. Humeral shaft fracture sustained during arm wrestling: report on 30 cases and review of the literature. J Trauma 1997;42:243-6.
- Kruczyński J, Jaszczur Nowicki J, Topoliński T, et al. Radiological and biomechanical analysis of humeral fractures occurring during arm wrestling. Med Sci Monit 2012;18:CR303-7.
- Ogawa K, Yoshida A, Matsumura N, Inokuchi W. Fractures of the humeral shaft caused by arm wrestling: a systematic review. JSES Rev Rep Tech 2022;2:505-12.
- Karadeniz E, Demiroz S, Oktem F, Memisoglu K, Kesemenli CC. Humeral fractures sustained during arm wrestling. Eur J Trauma Emerg Surg 2022;48:3109-14.
- Lee JK, Choi YS, Sim YS, Choi DS, Han SH. Dual plate fixation on distal third diaphyseal fracture of the humerus. Int Orthop 2017;41:1655-61.
- Shon HC, Yang JY, Lee Y, Cho JW, Oh JK, Lim EJ. Iatrogenic radial nerve palsy in the surgical treatment of humerus shaft fracture-anterolateral versus posterior approach: a systematic reviewand meta-analysis. J Orthop Sci 2023;28:244-50.
- Yildirim AO, Oken OF, Unal VS, Esmer AF, Gülçek M, Uçaner A. Avoiding iatrogenic radial nerve injury during humeral fracture surgery: a modified approach to the distal humerus. Acta Orthop Traumatol Turc 2012;46:8-12.
- Silva DC, Silva Z, Sousa Gda C, et al. Electromyographic evaluation of upper limb muscles involved in armwrestling sport simulation during dynamic and static conditions. J Electromyogr Kinesiol 2009;19:e448-57.
- Hong MK, Lin CY, Liao YS, Hong CK, Wang LH. Kinematic and electromyographic analysis of upper extremity in arm wrestling. Port J Sport Sci 2011;11 Suppl 2:267-70.
- Rämö L, Sumrein BO, Lepola V, et al. Effect of surgery vs functional bracing on functional outcome among patients with closed displaced humeral shaft fractures: the FISH randomized clinical trial. JAMA 2020;323:1792-801.
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