Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers
Background: Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending. Purpose: To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in...
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| Veröffentlicht in: | The American journal of sports medicine 2022-01, Vol.50 (1), p.229-237 |
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| creator | Schöffl, Volker Schöffl, Isabelle Flohé, Sascha El-Sheikh, Yasser Lutter, Christoph |
| description | Background:
Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending.
Purpose:
To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers.
Study Design:
Case series; Level of evidence, 4.
Methods:
On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score.
Results:
Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3.
Conclusion:
The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity o |
| doi_str_mv | 10.1177/03635465211056956 |
| format | Article |
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Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending.
Purpose:
To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers.
Study Design:
Case series; Level of evidence, 4.
Methods:
On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score.
Results:
Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3.
Conclusion:
The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465211056956</identifier><identifier>PMID: 34817275</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Algorithms ; Athletic Injuries - diagnosis ; Athletic Injuries - therapy ; Climbing ; Female ; Fingers & toes ; Growth Plate ; Humans ; Injuries ; Male ; Medical diagnosis ; Prospective Studies ; Sports ; Sports medicine ; Teenagers</subject><ispartof>The American journal of sports medicine, 2022-01, Vol.50 (1), p.229-237</ispartof><rights>2021 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-37638e720ae98d69482ec5f26e9953ca354d40374116212d7ae4e59c2cce093a3</citedby><cites>FETCH-LOGICAL-c411t-37638e720ae98d69482ec5f26e9953ca354d40374116212d7ae4e59c2cce093a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465211056956$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465211056956$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34817275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schöffl, Volker</creatorcontrib><creatorcontrib>Schöffl, Isabelle</creatorcontrib><creatorcontrib>Flohé, Sascha</creatorcontrib><creatorcontrib>El-Sheikh, Yasser</creatorcontrib><creatorcontrib>Lutter, Christoph</creatorcontrib><title>Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending.
Purpose:
To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers.
Study Design:
Case series; Level of evidence, 4.
Methods:
On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score.
Results:
Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3.
Conclusion:
The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.</description><subject>Adolescent</subject><subject>Algorithms</subject><subject>Athletic Injuries - diagnosis</subject><subject>Athletic Injuries - therapy</subject><subject>Climbing</subject><subject>Female</subject><subject>Fingers & toes</subject><subject>Growth Plate</subject><subject>Humans</subject><subject>Injuries</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Prospective Studies</subject><subject>Sports</subject><subject>Sports medicine</subject><subject>Teenagers</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9r3DAQxUVJabZJP0AuQZBLL071x5Ks47LdpIFAC03ORpHHu1pky5HklPTTV8umLTT0NAPzmzePeQidUXJJqVKfCJdc1FIwSomQWsg3aEGFYBXnUhyhxX5e7YFj9D6lHSGEKtm8Q8e8bqhiSizQz_WT8bPJLow49Njgz85sxpCys9XdFqKZYC49XvpNiC5vB9yHiK_cuIGI15Obts8JjMfXMfzIW_zNmwz4e46QEr4Zd3N0kLAb8bILHpKFMeOVd8MDxHSK3vbGJ_jwUk_Q_dX6bvWluv16fbNa3la2pjRXXEnegGLEgG46qeuGgRU9k6C14NaUD3Q14arAklHWKQM1CG2ZtUA0N_wEfTzoTjE8zpByO7jixHszQphTyyShWjWK6YJe_IPuwhzH4q5QVGqiaS0KRQ-UjSGlCH07RTeY-NxS0u6DaV8FU3bOX5TnhwG6Pxu_kyjA5QFIZgN_z_5f8RcPbZU1</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Schöffl, Volker</creator><creator>Schöffl, Isabelle</creator><creator>Flohé, Sascha</creator><creator>El-Sheikh, Yasser</creator><creator>Lutter, Christoph</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>202201</creationdate><title>Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers</title><author>Schöffl, Volker ; Schöffl, Isabelle ; Flohé, Sascha ; El-Sheikh, Yasser ; Lutter, Christoph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-37638e720ae98d69482ec5f26e9953ca354d40374116212d7ae4e59c2cce093a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Algorithms</topic><topic>Athletic Injuries - diagnosis</topic><topic>Athletic Injuries - therapy</topic><topic>Climbing</topic><topic>Female</topic><topic>Fingers & toes</topic><topic>Growth Plate</topic><topic>Humans</topic><topic>Injuries</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Prospective Studies</topic><topic>Sports</topic><topic>Sports medicine</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schöffl, Volker</creatorcontrib><creatorcontrib>Schöffl, Isabelle</creatorcontrib><creatorcontrib>Flohé, Sascha</creatorcontrib><creatorcontrib>El-Sheikh, Yasser</creatorcontrib><creatorcontrib>Lutter, Christoph</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schöffl, Volker</au><au>Schöffl, Isabelle</au><au>Flohé, Sascha</au><au>El-Sheikh, Yasser</au><au>Lutter, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2022-01</date><risdate>2022</risdate><volume>50</volume><issue>1</issue><spage>229</spage><epage>237</epage><pages>229-237</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
Finger epiphyseal growth plate stress injuries are the most frequent sport-specific injuries in adolescent climbers. Definitive diagnostic and therapeutic guidelines are pending.
Purpose:
To evaluate a diagnostic-therapeutic algorithm for finger epiphyseal growth plate stress injuries in adolescent climbers.
Study Design:
Case series; Level of evidence, 4.
Methods:
On the basis of previous work on diagnostics and treatment of finger epiphyseal growth plate stress injuries (EGPIs) in adolescent climbers, we developed a new algorithm for management of these injuries, which was implemented into our clinical work. During a 4-year period, we performed a prospective multicentered analysis of our patients treated according to the algorithm. Climbing-specific background was evaluated (training years, climbing level, training methods, etc); injuries were analyzed (Salter-Harris classification and UIAA MedCom score [Union Internationale des Associations d’Alpinisme]); and treatments and outcomes were recorded: union, time to return to climbing, VAS (visual analog scale), QuickDASH (shortened version of the Disabilities of the Arm, Shoulder, and Hand), and a climbing-specific outcome score.
Results:
Within the observation period, 27 patients with 37 independent EGPIs of the fingers were recorded (mean ± SD age, 14.7 ± 1.5 years; 19 male, 8 female; 66.7% competitive athletes). Regarding maturity at time of injury, the mean age at injury did not differ by sex. Average UIAA climbing level was 9.5 ± 0.8, with 6 ± 4.6 years of climbing or bouldering and 14 ± 9.1 hours of weekly climbing-specific training volume. Among the 37 injuries there were 7 epiphyseal strains, 2 Salter-Harris I fractures, and 28 Salter-Harris III fractures (UIAA 1, n = 7; UIAA 2, n = 30). Thirty-six injuries developed through repetitive stress, while 1 had an acute onset. Twenty-eight injuries were treated nonoperatively and 9 surgically. Osseous union was achieved in all cases, and there were no recurrences. The time between the start of treatment and the return to sport was 40.1 ± 65.2 days. The climbing-specific outcome score was excellent in 34 patients and good in 3. VAS decreased from 2.3 ± 0.6 to 0.1 ± 0.4 after treatment and QuickDASH from 48.1 ± 7.9 to 28.5 ± 3.3.
Conclusion:
The proposed management algorithm led to osseous union in all cases. Effective treatment of EGPIs of the fingers may include nonsurgical or surgical intervention, depending on the time course and severity of the injury. Further awareness of EGPI is important to help prevent these injuries in the future.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>34817275</pmid><doi>10.1177/03635465211056956</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The American journal of sports medicine, 2022-01, Vol.50 (1), p.229-237 |
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| source | SAGE Complete A-Z List; MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Algorithms Athletic Injuries - diagnosis Athletic Injuries - therapy Climbing Female Fingers & toes Growth Plate Humans Injuries Male Medical diagnosis Prospective Studies Sports Sports medicine Teenagers |
| title | Evaluation of a Diagnostic-Therapeutic Algorithm for Finger Epiphyseal Growth Plate Stress Injuries in Adolescent Climbers |
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