Finger growth plate injuries in adolescent sport climbers: A scoping review

This scoping review aims to better characterize finger growth plate injuries in adolescent sport climbers and to create a diagnostic and management algorithm for adolescent climbers after a finger growth plate injury. PubMed, EMBASE, and ScienceDirect databases were queried to identify articles from database inception to July 2024 for inclusion. The following search terms were used: (epiphys* OR physis OR physeal OR metaphys* OR "growth plate*") AND (climb*). Studies that examined adolescent sport climbers with a diagnosis of finger growth plate injury were included. Demographic and clinical information, injury characteristics, imaging and treatment modalities, and outcome data were extracted and pooled from all included studies. Eleven studies were included. In total, 149 physeal stress injuries occurred in 98 adolescent climbers with a mean age of 14 years and range of 10 to 18 years. A total of 146 injuries (98%) occurred at the proximal interphalangeal joint. Of these injuries, 74% were fractures, of which 97% occurred at the epiphysis. Baseline radiograph was the most used imaging modality for initial diagnosis of fracture. Treatment ranged from complete rest (21%) to surgical intervention (8%). Overall, return to sport time ranged from 2 weeks to 6 months, and 91% were able to return to climbing. Epiphyseal fractures are the most common growth plate injury reported in adolescent climbers. Identification of these injuries with clinical history and timely diagnostic imaging is critical to return to sport.