Abstract
A 33-year-old male presented with bilateral radial head fractures after weighted prone push-up exercise. The patient had Mason type I and II on right and left sides, respectively. He was managed conservatively with limited immobilisation and early range of motion exercises. The fracture healed and patient had no complaints at the last follow-up of 13 months. Bilateral radial head fracture is rare with push-up exercise, and can be successfully treated conservatively with immobilisation and early rehabilitation. Although push-up exercises are an excellent workout with known benefits, unusual modifications of standard techniques should be avoided.
Similar content being viewed by others
Change history
18 June 2021
A Correction to this paper has been published: https://doi.org/10.1007/s43465-021-00440-3
References
Pike, J. M., Athwal, G. S., Faber, K. J., & King, G. J. W. (2009). Radial Head Fractures-An Update. Journal of Hand Surgery (American Volume), 34(3), 557–565. https://doi.org/10.1016/j.jhsa.2008.12.024
Y. Rosenblatt, G. S. Athwal, & K. J. Faber. (2008). Current recommendations for the treatment of radial head fractures. Orthopedic Clinics of North America, 39(2), 173–185 (Elsevier). https://doi.org/10.1016/j.ocl.2007.12.008.
N. Pappas & J. Bernstein. (2010). Fractures in brief: Radial head fractures. Clinical Orthopaedics and Related Research, 468(3), 914–916 (Springer New York LLC). https://doi.org/10.1007/s11999-009-1183-1.
Hodge, J. C. (1999). Bilateral radial head and neck fractures. Journal of Emergency Medicine, 17(5), 877–881. https://doi.org/10.1016/S0736-4679(99)00099-2
Z. Shariff, K. J. Patel, A. Elbo, & I. Guisasola. (2005) Bilateral radial head fractures in a woman with trivial trauma. The Medscape Journal of Medicine, 7(3), 8
Deshmukh, N. V., & Shah, M. S. (2003). Bilateral radial head fractures in a martial arts athlete. British Journal of Sports Medicine, 37(3), 270–271. https://doi.org/10.1136/bjsm.37.3.270
Y. C. ABY Ng, L Bayam. (2007). Bilateral radial neck fractures—a case report. Malaysian Orthopaedic Journal, 1(2), 27–29
Mikawa, Y., Watanabe, R., & Fuse, K. (1994). Quadriplegia caused by push-up exercises. Archives of Orthopaedic and Trauma Surgery, 113(3), 174–175. https://doi.org/10.1007/BF00441629
Busche, M. N., Knobloch, K., Rosenthal, H., & Vogt, P. M. (2008). Stress fracture of the hamate body and fourth metacarpal base following military style push-ups: an unusual trauma mechanism. Knee Surgery, Sports Traumatology, Arthroscopy, 16(12), 1158–1160. https://doi.org/10.1007/s00167-008-0634-7
Mason, M. L. (1954). Some observations on fractures of the head of the radius with a review of one hundred cases. British Journal of Surgery, 42(172), 123–132. https://doi.org/10.1002/bjs.18004217203
L. D. R Verma, R Bansiwal, & G Ramachandran. (2009). Bilateral asymmetrical radial head fracture: An unusual case report. IJOS, 17(2).
Gawande, J., Jain, S., & Santoshi, J. A. (2017). Neglected bilateral radial head fracture with a rare presentation: a case report. Chinese Journal of Traumatology English Edition, 20(4), 246–248. https://doi.org/10.1016/j.cjtee.2016.07.003
Kaas, L., Struijs, P. A. A., Ring, D., Van Dijk, C. N., & Eygendaal, D. (2012). Treatment of mason type II radial head fractures without associated fractures or elbow dislocation: a systematic review. Journal of Hand Surgery (American Volume), 37(7), 1416–1421. https://doi.org/10.1016/j.jhsa.2012.03.042
Duckworth, A. D., et al. (2011). Radial head and neck fractures: functional results and predictors of outcome. Journal of Trauma: Injury, Infection & Critical Care, 71(3), 643–648. https://doi.org/10.1097/TA.0b013e3181f8fa5f
Åkesson, T., Herbertsson, P., Josefsson, P. O., Hasserius, R., Besjakov, J., & Karlsson, M. K. (2006). Primary nonoperative treatment of moderately displaced two-part fractures of the radial head. The Journal of Bone and Joint Surgery Series A, 88(9), 1909–1914. https://doi.org/10.2106/JBJS.E.01052
Paschos, N. K., Mitsionis, G. I., Vasiliadis, H. S., & Georgoulis, A. D. (2013). Comparison of early mobilization protocols in radial head fractures. Journal of Orthopaedic Trauma, 27(3), 134–139. https://doi.org/10.1097/BOT.0b013e31825cf765
Smits, A. J., Giannakopoulos, G. F., & Zuidema, W. P. (2014). Long-term results and treatment modalities of conservatively treated Broberg–Morrey type 1 radial head fractures. Injury, 45(10), 1564–1568. https://doi.org/10.1016/j.injury.2014.05.034
Siewe, J., et al. (2014). Injuries and overuse syndromes in competitive and elite bodybuilding. International Journal of Sports Medicine, 35(11), 943–948. https://doi.org/10.1055/s-0034-1367049
U. Aasa, I. Svartholm, F. Andersson, & L. Berglund. (2017). Injuries among weightlifters and powerlifters: A systematic review. British Journal of Sports Medicine, 51(4), 211–219 (BMJ Publishing Group). https://doi.org/10.1136/bjsports-2016-096037.
T. E. Hewett, C. Pasque, R. Heyl, & R. Wroble. (2005). Wrestling injuries.
Stahl, R. A., & Eckenrode, B. J. (2020). The nonoperative rehabilitation of a traumatic complete ulnar collateral ligament tear of the elbow in a high school wrestler: A case repoRT. International Journal of Sports Physical Therapy, 15(6), 1211–1221. https://doi.org/10.26603/ijspt20201211
M. M. Diesselhorst, G. M. Rayan, C. B. Pasque, & R. Peyton Holder. (2013). Survey of upper extremity injuries among martial arts participants. Hand Surgery, 18(2), 151–157. https://doi.org/10.1142/S0218810413500172.
Gupta, R. K., Soni, A., Malhotra, A., & Masih, G. D. (2017). Triceps tendon reconstruction using autologous semitendinosis graft in professional kabaddi player—a rare case report. Journal of Clinical Orthopaedics and Trauma, 8(Suppl 1), S38–S40. https://doi.org/10.1016/j.jcot.2017.05.007
Yang, J., et al. (2019). Association between push-up exercise capacity and future cardiovascular events among active adult men. JAMA Network Open, 2(2), e188341. https://doi.org/10.1001/jamanetworkopen.2018.8341
P. Pei-Hsi Chou, H.-H. Hsu, S.-K. Chen, S.-K. Yang, C.-M. Kuo, & Y.-L. Chou. (2011). Effect of push-up speed on elbow joint loading. Journal of Medical and Biological Engineering, 31(3), 161–168. https://doi.org/10.5405/jmbe.772.
Smith, J. M., Werner, F. W., & Harley, B. J. (2018). Forces in the distal radius during a pushup or active wrist motions. The Journal of Hand Surgery, 43(9), 806–811. https://doi.org/10.1016/j.jhsa.2018.05.020
Morrey, B. F., & Stormont, T. J. (1988). Force transmission through the radial head. The Journal of Bone & Joint Surgery Series A, 70(2), 250–256. https://doi.org/10.2106/00004623-198870020-00014
W. Dhahbi et al. (2018). Kinetic analysis of push-up exercises: a systematic review with practical recommendations. Sports Biomechanics. https://doi.org/10.1080/14763141.2018.1512149.
Contreras, B., Schoenfeld, B., Mike, J., Tiryaki-Sonmez, G., Cronin, J., & Vaino, E. (2012). The biomechanics of the push-up. The Strength & Conditioning Journal, 34(5), 41–46. https://doi.org/10.1519/SSC.0b013e31826d877b
Meena, S., Rastogi, D., Solanki, B., & Chowdhury, B. (2014). Stress fracture of ulna due to excessive push-ups. Journal of Natural Science, Biology and Medicine, 5(1), 225–227. https://doi.org/10.4103/0976-9668.127349
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Standard Statement
This article does not contain any studies with human or animal subjects performed by the any of the authors.
Informed Consent
For this type of study, informed consent is not required
Additional information
The original online version of this article was revised: The corresponding author was incorrectly assigned. The correct corresponding author is Subodh Kumar Pathak.
Rights and permissions
About this article
Cite this article
Pathak, S.K., Salunke, A.A., Chawla, J.S. et al. Bilateral Radial Head Fracture Secondary to Weighted Push-Up Exercise: Case Report and Review of Literature of a Rare Injury. JOIO 56, 162–167 (2022). https://doi.org/10.1007/s43465-021-00427-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s43465-021-00427-0