Stress injury of the distal radial growth plate. J Bone Joint Surg Br

Research and Training Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, England.
The Bone & Joint Journal (Impact Factor: 3.31). 12/1988; 70(5):834-6.
Source: PubMed


We report 21 cases of stress injury of the distal radial growth plate-occurring in gymnasts before skeletal maturity. The injury appears to be caused by inability of the growth plate to withstand rotational and compressive forces. Our observations have confirmed that the skeletal age of gymnasts is retarded, which increases the length of time during which the epiphysis is at risk of damage.

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    • "RADIUS Stress fractures of the radius have been described in gymnasts, a tennis player, a pool player, a cyclist, and a badminton player [83] [84] [85] [86] [87] [88] [89] [90] [91]. Stress fractures of the distal radial growth plate are seen frequently in young gymnasts [83] [84] [87] [89]. Ahluwalia and colleagues [88] have reported a skeletally mature female gymnast who presented with bilateral radial stress fractures, which were diagnosed by radionuclide imaging. "
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    ABSTRACT: Although less common than lower-extremity stress fractures, upper-extremity stress fractures are becoming recognized much more frequently. A majority of these fractures are caused by overuse and fatigue of the surrounding musculature and, as a result, may be prevented by appropriate training and conditioning. Diagnosis is made by history and physical examination with the aid of plain radiographs, bone scans, and MRI. Most of these fractures heal with a period of relative rest followed by a structured rehabilitation program. A small percentage of these fractures, however, may require surgical fixation. The present article reviews the different types of upper extremity and torso stress fractures seen in athletes, starting with the sternum and extending outward to the fingers. The presentation, diagnosis, mechanism of injury, treatment, prevention, and prognosis for each of these injuries will be discussed.
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    ABSTRACT: Gymnastics is a sport which involves substantial periods of upper extremity support as well as frequent impacts to the wrist. Not surprisingly, wrist pain is a common finding in gymnasts. Of all events, the pommel horse is the most painful. In order to study the forces of wrist impact, a standard pommel horse was instrumented with a specially designed load cell to record the resultant force of the hand on the pommel during a series of basic skills performed by a group of seventeen elite male gymnasts. The highest mean peak forces were recorded during the front scissors and flair exercises (1.5 BW) with peaks of up to 2.0 BW for some gymnasts. The mean peak force for hip circles at the center or end of the horse was 1.1 BW. The mean overall loading rate (initial contact to first loading peak) ranged from 5.2 BWs-1 (hip circles) to 10.6 BW s-1 (flairs). However, many recordings displayed localized initial loading spikes which occurred during 'hard' landings on the pommel. When front scissors were performed in an aggressive manner, the initial loading spikes averaged 1.0 BW in magnitude (maximum 1.8 BW) with an average rise time of 8.2 ms; calculated localized loading rates averaged 129 BW s-1 (maximum 219 BW s-1). These loading parameters are comparable to those encountered at heel strike during running. These impact forces and loading rates are remarkably high for an upper extremity joint not normally exposed to weight-bearing loads, and may contribute to the pathogenesis of wrist injuries in gymnastics.
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    ABSTRACT: In the past 15 to 20 years gymnastics has become very popular. The increased participation exposes a greater number of athletes to potential injury. The risk of gymnastic injuries seems to be proportional to the level of the athletes; the higher the level of gymnastics, the more hours are spent in practice, with a greater exposure time. With the increased risk in gymnastics, the incidence of acute injuries will also increase, and as the skill level increases, the load during the workout will also increase, providing more opportunity for chronic injuries. As in many sports, the ankle is the most injured body part. Some injuries, however, seem to be specific to gymnastics. In gymnastics the upper extremities are used as weightbearing limbs, so high impact loads are distributed through the elbow and wrist joint. Back problems appear to result not only from single episodes of macrotrauma, but also from repeated microtrauma caused by specific impact loads during vaults and hyperextension. Early detection is the key to treating elbow, wrist and back pain in the gymnast. Reinjury following an acute injury may be reduced by allowing for complete rehabilitation before returning to full practice. Some studies indicate that maturation rate could play a potential role in injury predisposition. The combination of periods of rapid growth and intense training could provide for conditions where the gymnast is more injury prone.
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