Missed upper extremity fractures in athletes

The majority of missed fractures in athletes are not overlooked because of difficulties recognizing them on radiographs. Rather, these fractures occur less commonly and often exist without accompanying disabilities, which makes their diagnosis more of a challenge. To complicate matters, evaluation of an injured athlete is often completed in the setting of the playing field, where distractions can be abundant. The physician treating sports-related injuries must not only follow the general principles of fracture evaluation and management, but must also be aware of the commonly understated fractures associated with the athlete's upper extremities. This manuscript reviews several such subtle fractures based on presentation, evaluation, and treatment.