Wrist Pain and Distal Growth Plate Closure of the Radius in Gymnasts

Albanese, Stephen A.; Palmer, Andrew K.; Kerr, Douglas R.; Carpenter, Creg; Lisi, D; Levinsohn, E. Mark

doi:10.1097/01241398-198901000-00005

Cited by 81 publications

(48 citation statements)

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“…19 A potential consequence of repetitive stress injury to the distal radial physis in gymnasts is premature physeal closure. 168 If this occurs prior to closure of the distal ulnar physis, positive ulnar variance may ensue which can lead to impingement of the triangular fibrocartilage complex, degenerative joint disease and chronic ulnar-sided wrist pain. In a systematic review of the literature, radiographical abnormalities consistent with distal radius physeal-stress reaction were described in 10-85% of gymnasts.…”

Section: Physeal Stress Injurymentioning

confidence: 99%

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

DiFiori¹,

et al. 2014

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BackgroundYouth sport participation offers many benefits including the development of self-esteem, peer socialisation and general fitness. However, an emphasis on competitive success, often driven by goals of elite-level travel team selection, collegiate scholarships, Olympic and National team membership and even professional contracts, has seemingly become widespread. This has resulted in an increased pressure to begin high-intensity training at young ages. Such an excessive focus on early intensive training and competition at young ages rather than skill development can lead to overuse injury and burnout. PurposeTo provide a systematic, evidenced-based review that will (1) assist clinicians in recognising young athletes at risk for overuse injuries and burnout; (2) delineate the risk factors and injuries that are unique to the skeletally immature young athlete; (3) describe specific high-risk overuse injuries that present management challenges and/or can lead to long-term health consequences; (4) summarise the risk factors and symptoms associated with burnout in young athletes; (5)provide recommendations on overuse injury prevention. MethodologyMedical Subject Headings (MeSHs) and text words were searched on 26 March 2012 from MEDLINE, CINAHL and PsycINFO. The search yielded 953 unique articles. Additional articles were found using cross-referencing. The process was repeated on 10 July 2013 to review any new articles since the original search. Screening by the authors yielded a total of 208 relevant sources that were used for this article. Recommendations were classified using the Strength of Recommendation Taxonomy (SORT) grading system. Definition of overuse injuryOveruse injuries occur due to repetitive submaximal loading of the musculoskeletal system when rest is not adequate to allow for structural adaptation to take place. Injury can involve the muscletendon unit, bone, bursa, neurovascular structures and the physis. Overuse injuries unique to young athletes include apophyseal injuries and physeal stress injuries. EpidemiologyIt is estimated that 27 million US youth between 6 and 18 years of age participate in team sports. The National Council of Youth Sports survey found that 60 million children aged 6-18 years participate in some form of organised athletics, with 44 million participating in more than one sport. There is very little research specifically on the incidence and prevalence of overuse injuries in children and adolescents. Overall estimates of overuse injuries versus acute injuries range from 45.9% to 54%. The prevalence of overuse injury varies by the specific sport, ranging from 37% (skiing and handball) to 68% (running). Overuse injuries are underestimated in the literature because most of the epidemiological studies define injury as requiring a time loss from participation. Risk factorsPrior injury is a strong predictor of future overuse injury. Overuse injuries may be more likely to occur during the adolescent growth spurt. The physes, apophyses and articular surfaces in skeletally immat...

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Section: Physeal Stress Injurymentioning

confidence: 99%

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

DiFiori¹,

et al. 2014

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“…A &dquo;stress reaction&dquo; of the distal radial physis has been reported,' but most are cured with rest and without sequellae.5°34-3s,44 A Madelung-like deformity of the wrist in gymnasts has also been described. 1,8,39,41 The purpose of this survey was to determine the occurrence and amount of ulnar overgrowth in a large sample of high-level female gymnasts' and to relate it to height and weight, chronologic age, performance level, and training conditions.…”

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confidence: 99%

Gymnast Wrist: An Epidemiologic Survey of Ulnar Variance and Stress Changes of the Radial Physis in Elite Female Gymnasts

et al. 1994

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The ulnar variance in female gymnasts attending the World Championship Artistic Gymnastics Rotterdam 1987 was measured. There was a marked increase in the ulnar length in adult as well as immature gymnast compared with nonathletes. The changes in relative ulnar length were correlated to weight, height, and skeletal age of the athletes. In 10% of the gymnasts' wrists we noted so-called "stress-related changes" of the distal physis of the radius. Repetitive injury and compression of the wrist leads to a premature closure of the distal radial growth plate resulting in secondary ulnar overgrowth.

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“…10.8 ) [ 40 ]. Premature closure of the distal radial physis has also been reported [ 41 ]. Pseudo-Madelung appearance has been described, secondary to premature closure of the ulnar aspect of the radial physis [ 42 ].…”

Section: Imagingmentioning

confidence: 98%

The Hand and Wrist: Acquired Disorders

Pai

Smith

Strouse

2014

Pediatric Orthopedic Imaging

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This chapter discusses the clinical and imaging characteristics of acquired lesions that are encountered in the pediatric hand and wrist. The fi rst section addresses three categories of fractures: radial and ulnar fractures, carpal bone fractures, and hand fractures. The second section focuses on overuse injuries including Kienböck osteonecrosis, gymnast wrist, and ulnocarpal impaction. Disorders involving tendons and ligaments are then discussed, addressing tendon pathology in the extensor compartments, trigger thumb, carpal instability, the ulnar collateral ligament of the thumb, and the triangular fi brocartilage complex. Following this in-depth section on tendons and ligaments, imaging of neurovascular injuries and ganglion cysts is addressed. The chapter closes with a discussion of burns and frostbite.

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Wrist Pain and Distal Growth Plate Closure of the Radius in Gymnasts

Cited by 81 publications

References 0 publications

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

Gymnast Wrist: An Epidemiologic Survey of Ulnar Variance and Stress Changes of the Radial Physis in Elite Female Gymnasts

The Hand and Wrist: Acquired Disorders

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