Rib Stress Fractures and a Novel Muscle-Sparing Rib Fixation Plating in an Elite Tennis Player: A Systematic Review of the Literature and Case Report

Sports Health. 2024 Jul-Aug;16(4):573-580. doi: 10.1177/19417381231195271. Epub 2023 Sep 9.

Abstract

A nationally ranked Division One female collegiate tennis player presented with pain in the chest and right posterior rib region after feeling a popping sensation during a routine overhead movement. The patient was eventually diagnosed with 2 lower rib stress fractures. After unsuccessful conservative management, the player underwent an open reduction and internal fixation and autologous bone grafting of the sixth and seventh ribs with a muscle-sparing approach and was able to return to full competition. We present this case along with a systematic review of the literature regarding rib stress fractures, which included 6 separate online data sources (PubMed, EMBASE, Cochrane, CINAHL, SportDiscus, and Medline). The successful surgical intervention demonstrates a significant option for elite athletes who wish to return to competition but have been unable to with standard of care conservative management of rib stress fractures.

Keywords: athlete; rib fracture; sport; stress fracture.

Publication types

  • Systematic Review
  • Case Reports

MeSH terms

  • Bone Plates*
  • Bone Transplantation
  • Female
  • Fracture Fixation, Internal* / methods
  • Fractures, Stress* / diagnostic imaging
  • Fractures, Stress* / surgery
  • Humans
  • Return to Sport
  • Rib Fractures* / surgery
  • Tennis* / injuries
  • Young Adult