CASE REPORTS

CASE 1

While performing the ‘wining dance’ for his companions, the left leg of a healthy 42-year old obese male suddenly fractured in a spiral manner while he was swaying towards the ground in the typical spiral fashion[fig. 1]. The pointed end of the tibia pierced the skin from within and converted it to a compound fracture. There was no underlying pathologic condition.

Figure 1

Figure 1: A picture of the spiral fracture of the tibia & fibula resulting from the spiral downward movements of the ‘wining dance’.

CASE 2

DISCUSSION

Compound tibia and fibula fractures are common injuries typically associated with direct trauma during a motor vehicle accident ₁, football injures ₂ or an accidental fall from a height.

Usually a twisting force causes a spiral fracture of the tibia and fibula 1 and some articles state stress fractures of the tibia and fibula are a result of increase of inappropriate strain with pre-existing risk factors such as connective tissue disorders, osteoperosis, early menopause, methotrexate, corticosteroids and prolonged immobilization₃, but can occur due to repetitive stress which is seen in many recruits, runners and ballet dancers1.

There are few esoteric causes for a spiral tibia and fibula fracture to occur with only one case of a closed tibia and fibula fracture due to loss of attention secondary to excessive use of laxatives with diuretics₄.

‘Wining’ in particular has been associated with paraphimosis in young males and is documented as an esoteric cause of paraphimosis. ₅

We postulate the downward, swaying, spiral movements of the legs in these overweight males induced enough rotational force to fracture the long bones of the legs and suggest that persons with known medical disorders, which predispose to osteoporosis or those who are overweight proceed in a cautious manner when performing the ‘wining dance’.

Figure 2

Figure 2: "Wining" with downward swaying movements of his legs towards the ground

CORRESPONDENCE

Dr. Michael J. Ramdass
100 East Drive,
Champs Fleurs,
St. Joseph,
Trinidad, West Indies.
E-mail: jimmyramdass@hotmail.com