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Fly Fishing-related lesser tuberosity avulsion in an adolescent.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Teixeira, Rafael P. Johnson, Alan R. Higgins, Brendan T. Carrino, John A. McFarland, Edward G.
Description	Country affiliation: United States Author Affiliation: Teixeira RP ( Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD 21224-2780, USA.)
Abstract	Stress lesions of the shoulder in athletic and active adolescents are most commonly associated with overhead sports. One of the most uncommon stress lesions of the shoulder in adolescents is an avulsion of the lesser tuberosity of the proximal humerus. To our knowledge, only 2 other cases of lesser tuberosity avulsions from repetitive motion have been reported, both of which were secondary to baseball pitching.This article describes a case of an isolated partial avulsion of the lesser tuberosity of the humerus in an adolescent as a result of repetitive stress from fly fishing. The patient had no symptoms in his shoulder until after casting for approximately 10 hours a day for 3 days. He presented with anterior shoulder pain that worsened with abduction and external rotation. On examination, he had tenderness over the lesser tuberosity and pain with subscapularis muscle testing, such as the lift-off test. He had a negative apprehension sign but no signs of a superior labrum tear. Conventional radiography with an axillary view confirmed the diagnosis. He recovered with rest and gradual return to activities. Two years after injury, the patient had no limitations functionally, and his shoulder examination was normal.This case highlights the importance of being aware that (1) this lesion can occur in activities other than baseball, (2) characteristic physical findings exist with this lesion, (3) obtaining an axillary radiograph can confirm diagnosis, and (4) these avulsions can be treated successfully with nonoperative interventions.
File Format	HTM / HTML
ISSN	01477447
e-ISSN	19382367
DOI	10.3928/01477447-20120426-34
Journal	Orthopedics
Issue Number	5
Volume Number	35
Language	English
Publisher	SLACK Incorporated
Publisher Date	2012-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopedics Athletic Injuries Fractures, Stress Pathology Intra-articular Fractures Shoulder Dislocation Diagnosis Shoulder Fractures Tendon Injuries Adolescent Physiopathology Radiography Recovery Of Function Therapy
Content Type	Text
Resource Type	Case study Article
Subject	Orthopedics and Sports Medicine Surgery

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