Conservative Management of a Distal Humerus Spiral Fracture Sustained During Arm Wrestling: A Case Report and Literature Review

Arm wrestling is a popular recreational activity that involves intense and repetitive muscular contractions of the upper extremity. Arm wrestling can result in various musculoskeletal injuries, including bone fractures. Humeral shaft fractures, particularly spiral fractures, are the most common fractures resulting from arm wrestling. Here, we present a case of a 25-year-old male patient who sustained a distal humerus spiral fracture during an arm-wrestling competition. The patient was managed conservatively with external reduction, cast stabilization, and physiotherapy with good outcomes. Despite initial angulation and rotation, the fracture healed well, and the patient regained full function of his arm within eight weeks. This case highlights the biomechanical aspects and risk factors of this type of fracture during arm wrestling and the value of protective measures such as proper technique, training, and protective equipment. It also highlights the potential for conservative management in such cases.

Clinical Outcomes of Single Versus Double Plating in Distal-Third Humeral Fractures Caused by Arm Wrestling: A Retrospective Analysis

Background and Objectives: Arm wrestling is a simple and popular activity among young people that causes distal-third humeral fractures. However, injury to the young population may cause economic loss; therefore, they need to return to work as soon as possible. Accordingly, we aimed to compare radiological and functional outcomes of distal-third humeral fractures caused by arm wrestling treated with double and single plating. Materials and Methods: Thirty-four patients with distal-third humeral fractures caused by arm wrestling were treated between January 2015 and January 2021. They were separated into double- and single-plating groups and treated using a triceps-sparing approach. Regular follow-up was performed to evaluate elbow functionality, range of motion, bone union, and complications; the American Shoulder and Elbow Surgeons score was used for functional assessment. Results: Patients treated with single plating exhibited union rate, union time, and elbow range of motion similar to those of patients treated with double plating; however, they exhibited better pain and functional outcomes (American Shoulder and Elbow Surgeons score) at 2 weeks, 1 month, and 3 months postoperatively (84.50 ± 5.01 vs. 61.70 ± 12.53 at 2 weeks, 96.20 ± 2.63 vs. 84.25 ± 14.56 at 1 month, and 100.00 vs. 94.76 ± 9.71 at 3 months, p < 0.05). The two groups exhibited no significant differences after 1 year (100.00 vs. 98.54 ± 3.99, p < 0.13). The overall complication rate was significantly higher in patients treated with double plating than in those treated with single plating (18.75% vs. 5.56%). Radial nerve palsy was observed in patients in both groups. Conclusions: In patients with distal-third humeral fractures caused by arm wrestling, single plating provides a union rate and elbow range of motion similar to those of double plating, with significantly fewer complications and lower surgical time and blood loss with improved early functional outcomes.

Humeral Shaft Fracture Sustained During Arm Wrestling with Review of Factors Contributing to its Causation

Introduction:

Humeral shaft fractures are the most common injury sustained in arm wrestling, and its various biomechanical, anatomical, kinematic and electromyographic aspects have been studied and reported. We present a series of six cases of humeral shaft fractures in the arm wrestlers and a review of basic science studies to determine the factors contributing to their causation.

Materials and methods:

Six humeral shaft fractures associated with arm wrestling were treated between December 2018 and January 2020. The medical records and radiographs were retrospectively reviewed. In addition, the characteristics of the patients, their opponents, and the fractures were noted in a pre-designed data sheet.

Results:

There were six men with an average age of 27.5 years (SD ± 8.9). All were amateurs who were occasional arm wrestlers. Three fractures each were sustained in the sitting and standing position, four in the losing phase, one in the winning phase, and one in the stalling phase. The dominant side humerus was involved in all but one case. The fracture types were 12-A1 (n=4); 12-B1 (n=1); 12-A2 (n=1). Three fractures were treated by open reduction and internal fixation, while three were treated conservatively with satisfactory healing.

Conclusion:

Humeral shaft fractures in arm wrestling are common in amateurs. There is no association of the fracture with the position of the players or the phase of the match. However, arm wrestlers should be aware of this complication and should receive proper guidance to reduce the risk of humeral shaft fractures.

Use of sonography in assessing elbow medial collateral ligament injury after arm wrestling

Medial collateral ligament injury is an infrequent occurrence in arm wrestlers. We report here a male patient who injured his left elbow while arm wrestling. Ultrasonography showed a medial collateral ligament tear. We assessed both elbows using ultrasonography at his 3-year follow-up visit. Dynamic ultrasonography showed a decreased gap at the ulnotrochlear joint space in his left elbow. A medial collateral ligament tear in his right elbow was also evident using ultrasonography. This case report shows the advantages of ultrasonography, especially dynamic ultrasonography, in the evaluation of elbow injury. Ultrasonography provides more information than valgus stress radiography, arthrography, and magnetic resonance imaging in the assessment of medial collateral ligament injury. In addition, the contralateral side can readily be assessed for comparison during ultrasonography.