Epiphyseal Fractures in Adolescent Sport Climbers

Introduction With the growing popularity of sport climbing, injuries of the fingers have become more frequent. Lesions of the flexor tendon pulley system are well known in adults, but epiphyseal injuries of the fingers in adolescent climbers seem to be underestimated. We report a series of epiphyseal injuries that were not seen on conventional radiographs.

Material and Methods Following clinical examination and radiographic imaging, 12 adolescent sport climbers (14–16 years of age; male-to-female ratio: 8:4) underwent magnetic resonance imaging (MRI) of the fingers (D3: n = 9; D4: n = 3). In one case, digital volume tomography (DVT) imaging was performed to proof a suspected fracture.

Results No distinct trauma was reported. All climbers experienced painful restriction of a swollen interphalangeal joint. No lesions were seen on conventional radiographs. MRI showed T2 hyperintensity adjacent to the growth plates indicating epiphyseal fractures, proven in one case by DVT imaging (Salter-Harris °I, n = 1; II, n = 1; III, n = 10). Following 2 to 3 weeks of hiatus from the sport, all climbers were able to restart their training schedule.

Conclusion In general, epiphyseal injuries are underestimated in adolescent sport climbers. Salter-Harris lesions I and II as well as III in a few cases may only be seen on MRI.