Proposal of a specific classification of primary periphyseal stress injuries in adolescent rock climbers
Affiliations
- 1Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany.
- 2Department of Trauma Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
- 3Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO, United States.
- 4School of Clinical and Applied Sciences, Leeds Becket University, Leeds, United Kingdom.
- 5Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, Bayreuth, Germany.
- 6Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, San Sebastian, Spain.
- 7Camp4 Human Performance, Salt Lake City, UT, United States.
- 8Department of Radiology and Imaging Sciences, School of Medicine, The University of Utah, Salt Lake City, UT, United States.
- PMID: 40895403
- PMCID: PMC12395177
- DOI: 10.3389/fspor.2025.1596624
Abstract
Introduction: Primary Periphyseal Stress Injuries (PPSI) of the hand and fingers are relatively uncommon but are most frequently seen in adolescent rock climbers. A major limitation in the current literature on PPSIs is the lack of a standardized nomenclature and radiological classification. This gap complicates the accurate diagnosis, treatment, and comparison of outcomes across studies.
Methods: We conducted a comprehensive structured literature review of the relevant PPSI literature in climbers using Pubmed, SPORTDiscus, and Web of Science to identify the relevant studies on PPSI in adolescent rock climbers. Based on the findings from existing research and our own data, we propose a new classification system for these injuries.
Results: A five-grade classification system, with subgroups, has been developed based on both clinical and radiographic data. The classification is presented in a table, along with figures illustrating examples of the various injury types.
Conclusion: Additional research is required to assess the reliability and reproducibility of this classification system. We plan to conduct these evaluations in future studies.
Keywords: epiphyseal fractures; finger injury; fracture classification; periphyseal fractures; rock climbing.
