Hindawi Publishing Corporation ISRN Orthopedics Volume 2013, Article ID 962609, 3 pages http://dx.doi.org/10.1155/2013/962609 Clinical Study Humeral Shaft Fractures Secondary to Hand Grenade Throwing Bahattin Kerem Aydin, 1 Ramazan Akmese, 2 and Mustafa Agar 3 1 Selcuk University, Faculty of Medicine Orthopaedics and Traumatology Clinic, 42070 Konya, Turkey 2 Ankara Ataturk Educational Hospital Orthopaedics and Traumatology Clinic, 06100 Ankara, Turkey 3 Denizli State Hospital Orthopaedics and Traumatology Clinic, 20110 Denizli, Turkey Correspondence should be addressed to Bahattin Kerem Aydin; bkaydin@yahoo.com Received 10 March 2013; Accepted 3 April 2013 Academic Editors: A. Combal´ ıa and T. Matsumoto Copyright © 2013 Bahattin Kerem Aydin et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A series of fve cases were presented in which similar fractures of the shafof the humerus occurred during the hand grenade throwing activity during the military education. All the fractures were in the 1/3 distal humeral shaf, and butterfy fragments were accompanying in two soldiers. All the fractures healed without any clinical complications with conservative treatment. Te mechanism of the fracture is discussed with reference to the recent literature. 1. Introduction Humerus fractures are generally secondary to the direct trauma [1, 2]. Fractures of the shafof the humerus as a result of muscular violence are uncommon. Spiral fractures of the humerus have been reported in throwing sports such as baseball, sofballs, handballs, javelins, and hand grenades [3–5]. Tis type of fractures is also reported among the hand wrestlers [6]. Sometimes, especially in teenagers and geriatric population, this type of violence can cause spiral fractures who has oncologic bone disease. Trowing fractures of the humeral shaf are controversial whether they are related to a stress fracture or a sudden intense torsional load. Stress fracture patients generally have complaints of arm pain and repeating throwing activity before the fracture. But in torsional stress group, there is always a history of sudden intense torsional activity just before the fracture. In the present study, spiral humeral shaf fractures are secondary to the hand grenade throwing in fve military recruits. Te causes of these fractures and the literature related to the hand grenade throwing were also reviewed. 2. Materials and Methods Between August 2008 and January 2009, 5 male military recruits were admitted to the Emergency Department of A˘ grı Military Hospital with the right humerus shaf fractures dur- ing hand grenade throwing training period. Average patient age was 20.2 years (range 19–22). All the patients were right- handed, and none of them had an experience in throwing sports before their military obligation. Te recruits reported that they used the maximum strength when throwing the hand grenade. According to their history, all the fractures occurred just before the hand grenade release. All fractures were closed and extra-articular. All the fractures were at the junction of the middle and distal third of the humeral shaf(Figure 1). Two of them had a butterfy fragment. No patient had a neurovascular injury. All patients were admitted to the clinic on the day of injury. Initial fracture stabilization was achieved with U- splint and the Velpeau bandage for all patients. Patients were systematically examined for accompanying any mus- culoskeletal disease. Because pathologic fracture was not suspected on plain radiographs, any further imaging tech- niques were not performed. On radiographs, average varus- valgus angulation was 12  [7–15], and anterior-posterior angulation was 11.2  [9–13]. All the patients underwent nonsurgical treatment. Tree-week U-splint and Velpeau bandage and then custom-made prefabricated functional brace were applied (Figure 2). Average time to union time was 10.6 [9–13] weeks. Functional examination according to the Hunter Classifcation was G5 [7]. No patient had lack of elbow motion. No patient required formal physical therapy