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Case report
Ulnar stress reaction in an axillary crutch user
  1. Ranita Harpreet Kaur Manocha1,2 and
  2. Jenelle Weidner3
  1. 1Physical Medicine & Rehabilitation, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
  3. 3Occupational Therapy, University of Alberta Faculty of Rehabilitation Medicine, Edmonton, Alberta, Canada
  1. Correspondence to Dr Ranita Harpreet Kaur Manocha; ranita.manocha{at}


Ulnar stress fractures have been reported in athletes performing repetitive, high-impact activities, such as baseball pitchers and gymnasts. Crutch-assisted walking also results in cyclical forearm loading. We report the first case of ulnar stress reaction due to axillary crutch use. A 23-year-old right-handed woman experienced right forearm pain and imaging confirmed a right ulnar stress injury. The patient was also found to have mild hypercortisolism, low bone mass and vitamin D deficiency. Crutches were discontinued and physical therapy to normalise weight bearing through the left leg was prescribed. The patient’s right forearm symptoms resolved and she was started on oral vitamin D supplementation. Axillary crutch use may result in ulnar stress injury, particularly in vulnerable populations. The addition of an upper extremity injury to someone with impaired mobility may compound disability. As such, clinicians should be aware of the clinical presentation of ulnar stress fractures in the long-term axillary crutch user.

  • sports and exercise medicine
  • rehabilitation medicine
  • orthopaedics
  • nutrition and metabolism
  • endocrinology

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  • Contributors RHKM conceived of and designed the article. JW performed a systematic literature search. Both RHKM and JW analysed the literature, drafted the manuscript and critically revised the manuscript. Both authors read and approved the final manuscript and agree to be accountable for all aspects of the work if questions arise related to its accuracy or integrity.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.