title: Epiphyseal fractures of the finger middle joints in young sport climbers.
abstract: OBJECTIVE
  As competition climbing becomes increasingly popular, younger climbers are entering the sport, and some are among the top-level athletes. This early start combined with intensive training methods can lead to radiographic changes in the fingers and even osteoarthrosis. Since 1994, we have been observing an increasing number of nontraumatic epiphyseal fractures in young athletes.
  
  
  METHODS
  Twenty-four cases of young climbers with nontraumatic epiphyseal fractures of the finger middle joints are presented.
  
  
  RESULTS
  The average age of the climbers was 14.5 (+/- 0.9) years; 23 were boys, and 1 was a girl. Eight (33%) fractures were in an early stage, whereas in 16 (67%) a longer time interval elapsed between the onset of symptoms and the presentation for evaluation. All radiographs showed an epiphyseal fracture of the dorsal base of the middle phalanx of the finger; 20 patients presented a Salter-Harris III fracture and 4 presented a Salter-Harris II epiphysiolysis. An acute injury was not evident in any of the patients. All fractures were thus fatigue fractures caused by repetitive stress.
  
  
  CONCLUSIONS
  Chronic finger pain in young and intensively training climbers must be carefully evaluated, and radiographic studies need to be performed. The risk of epiphyseal injuries must be minimized by eliminating intensive power training in the schedules of athletes of this age.
authors.affiliation: Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Bamberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hochholzer
authors.forename: Volker Rainer
authors.initials: VR
authors.lastname: Schöffl
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000473:pathology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005858:Germany / Q000453:epidemiology; D006132:Growth Plate / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008499:Medical Records; D009051:Mountaineering / Q000293:injuries*; D011859:Radiography; D012189:Retrospective Studies; D000072042:Salter-Harris Fractures