PDF herunterladen
Semin Musculoskelet Radiol 2005; 09(4): 334-345
DOI: 10.1055/s-2005-923378
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of Rock Climbing Injuries

Carlo Martinoli1 , Stefano Bianchi2 , Anne Cotten3
  • 1Cattedra di Radiologia “R”-DICMI-Università di Genova, Largo Rosanna Benzi 8, I-16132, Genova, Italy
  • 2Clinique et Fondation des Grangettes, CH-1224 Chene-Bougeries, Switzerland
  • 3Department of Bone Radiology, Centre Hospitalier Universitarie de Lille, Hopital Roger Salengro, Boulevard de Pr. Jules Leclercq. 59037 Lille Cedex, France
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
29. November 2005 (online)

Auch verfügbar auf
    Lizenzen und Reprints

ABSTRACT

Competition climbing has grown increasingly in popularity, and many people are being drawn to this sport with a parallel increase in the occurrence of sport-related injuries. One of the most common and unique lesions occurring in the rock climbing population is the closed rupture of the flexor pulley system of the fingers. This lesion is strictly related to some climbing techniques in which the entire body weight is placed on fingerholds, which causes bowstringing of the flexor tendons with subsequent loss of strength across the full range of motion of the finger. This article summarizes the current literature regarding the application of imaging modalities in the diagnosis of rock climbing injuries with a specific focus on ultrasound and magnetic resonance imaging. Biomechanics of the sporting activity and resultant pathophysiologic and clinical considerations concerning flexor pulley system injuries are also discussed.

KEYWORDS

Annular pulleys - hand injuries - rock climbing - ultrasound - MR imaging

REFERENCES

  • 1 Haas J C, Meyers M C. Rock climbing injuries.  Sports Med. 1995;  20 199-205
    CrossrefPubMedSuche in Google Scholar
  • 2 Schöffl V, Hochholzer T, Imhoff A. Radiographic changes in the hands and fingers of young, high-level climbers.  Am J Sports Med. 2004;  32 1688-1694
    CrossrefPubMedSuche in Google Scholar
  • 3 Logan A J, Makawana N, Mason G et al.. Acute hand and wrist injuries in experienced rock climbers.  Br J Sports Med. 2004;  38 545-548
    CrossrefPubMedSuche in Google Scholar
  • 4 Bollen S R, Gunson C K. Hand injuries in competition climbers.  Br J Sports Med. 1990;  24 16-18
    CrossrefPubMedSuche in Google Scholar
  • 5 Rohrbough J T, Mudge M K, Schilling R C. Overuse injuries in the elite rock climber.  Med Sci Sports Exerc. 2000;  32 1369-1372
    CrossrefPubMedSuche in Google Scholar
  • 6 Rispler D, Greenwald D, Shumway S et al.. Efficiency of the flexor tendon pulley system in human cadaver hands.  J Hand Surg [Am]. 1996;  21 444-450
    PubMedSuche in Google Scholar
  • 7 Bollen S R. Injury to the A2 pulley in rock climbers.  J Hand Surg [Br]. 1990;  15 268-270
    CrossrefPubMedSuche in Google Scholar
  • 8 Lin G T, Amadio P C, An K N et al.. Functional anatomy of the human digital flexor pulley system.  J Hand Surg [Am]. 1989;  14 949-956
    CrossrefPubMedSuche in Google Scholar
  • 9 Lin G T, Cooney W P, Amadio P C et al.. Mechanical properties of human pulleys.  J Hand Surg [Br]. 1990;  15 429-434
    CrossrefPubMedSuche in Google Scholar
  • 10 Marco R A, Sharkey N A, Smith T S, Zissimos A G. Pathomechanics of closed rupture of the flexor tendon pulleys in rock climbers.  J Bone Joint Surg. 1998;  80 1012-1019
    PubMedSuche in Google Scholar
  • 11 Hauger O, Chung C B, Lektrakul N et al.. Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT and US with and without contrast material distension of the tendon sheath.  Radiology. 2000;  217 201-212
    PubMedSuche in Google Scholar
  • 12 Manske P R, Lesker P A. Strength of human pulleys.  Hand. 1977;  9 147-152
    PubMedSuche in Google Scholar
  • 13 Wyatt J P, McNaughton G W, Grant P T. A prospective study of rock climbing injuries.  Br J Sports Med. 1996;  30 148-150
    CrossrefPubMedSuche in Google Scholar
  • 14 Gabl M, Rangger C, Lutz M et al.. Disruption of the finger flexor pulley system in elite rock climbers.  Am J Sports Med. 1998;  26 651-655
    CrossrefPubMedSuche in Google Scholar
  • 15 Quaine F, Vigouroux L, Martin L. Effect of simulated rock climbing finger postures on force sharing among the fingers.  Clin Biomech (Bristol, Avon). 2003;  18 385-388
    CrossrefPubMedSuche in Google Scholar
  • 16 Seiler III J G, Lerversedge F J. Digital flexor sheath: repair and reconstruction of the annular pulleys and membranous sheath.  J South Orthop Assoc. 2000;  9 81-90
    PubMedSuche in Google Scholar
  • 17 Bodner G, Rudish A, Gabl M et al.. Diagnosis of digital flexor tendon annular pulley disruption: comparison of high frequency ultrasound and MRI.  Ultraschall Med. 1999;  20 131-136
    Thieme ConnectPubMedSuche in Google Scholar
  • 18 Klauser A, Bodner G, Frauscher F et al.. Finger injuries in extreme rock climbers. Assessment of high resolution ultrasonography.  Am J Sports Med. 1999;  27 733-737
    CrossrefPubMedSuche in Google Scholar
  • 19 Klauser A, Frauscher F, Bodner G et al.. Finger pulley injuries in extreme rock climbers: depiction with dynamic US.  Radiology. 2002;  222 755-761
    CrossrefPubMedSuche in Google Scholar
  • 20 Martinoli C, Bianchi S, Derchi L E et al.. Sonographic evaluation of digital annular pulleys tears.  Skeletal Radiol. 2000;  29 387-391
    CrossrefPubMedSuche in Google Scholar
  • 21 Le Viet D, Rousselin B, Roulot E et al.. Diagnosis of digital pulley rupture by computed tomography.  J Hand Surg [Am]. 1996;  21 245-248
    PubMedSuche in Google Scholar
  • 22 Parellada J A, Balkissoon A R, Hayes C W, Conway W F. Bowstring injury of the flexor tendon pulley system: MR imaging.  AJR Am J Roentgenol. 1996;  167 347-349
    PubMedSuche in Google Scholar

Carlo MartinoliM.D. 

Cattedra di Radiologia “R”-DICMI-Università di Genova

Largo Rosanna Benzi 8, I-16132, Genova, Italy