Thrower's Fracture With Subsequent Compartment Syndrome Requiring Emergent 2 Compartment Upper Extremity Fasciotomy.

Abstract

Introduction: A thrower's fracture is a mid-to-distal third humerus fracture that commonly presents as an audible pop with severe arm pain sustained during the throwing motion. Although thrower's fracture has been described previously in the literature, this report is the first to demonstrate compartment syndrome as its potential sequel.

Case presentation: A 25-year-old semi-professional pitcher presented to the emergency department with severe right arm pain following a pitch. He described hearing an audible pop with subsequent severe pain. He was found to have elevated compartment pressures in his upper arm and was rushed to the operating room for a 2 compartment fasciotomy. The thrower's fracture classically presents as an audible pop with subsequent arm pain in male patients aged 20-30 years during the acceleration phase of throwing. A potential well-known sequel is radial nerve palsy, which occurs in roughly 5-11% of patients. A sequel which has not been previously described is the subsequent development of compartment syndrome.

Conclusion: Compartment syndrome should be monitored in patients with thrower's fractures, as it is a limb-threatening condition that can subsequently develop.