Proposal of a specific classification of primary periphyseal stress injuries in adolescent rock climbers

V Schöffl; X Iruretagoiena; T Nelson; Paulo Miro

doi:10.3389/fspor.2025.1596624

Proposal of a specific classification of primary periphyseal stress injuries in adolescent rock climbers

Front Sports Act Living. 2025 Aug 14:7:1596624. doi: 10.3389/fspor.2025.1596624. eCollection 2025.

Authors

V Schöffl^{1

2

3

4

5}, X Iruretagoiena⁶, T Nelson⁷, Paulo Miro⁸

Affiliations

¹ Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany.
² Department of Trauma Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
³ Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO, United States.
⁴ School of Clinical and Applied Sciences, Leeds Becket University, Leeds, United Kingdom.
⁵ Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, Bayreuth, Germany.
⁶ Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, San Sebastian, Spain.
⁷ Camp4 Human Performance, Salt Lake City, UT, United States.
⁸ Department of Radiology and Imaging Sciences, School of Medicine, The University of Utah, Salt Lake City, UT, United States.

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.