Abstract
Feet Injuries in Rock Climbers
Injuries to the upper extremities in rock climbers are widely discussed in current literature, but there is scarce literature concerning lower extremity injuries. Nearly 50% of acute injuries involve the legs and feet, most frequently strains, contusions, and fractures of the calcaneus and talus. The authors reviewed current literature and reported common lower extremity injury patterns and factors associated with injury. Wall-collision falls (climber impacts in a vertical plane) and ground falls (climber impacts in a horizontal plane) are the most common inciting factors for lower extremity injuries. Wall-collision falls are associated with contusions and compound fractures whereas ground falls can cause serious fractures of the talus, calcaneus, or ankle joint. Distortions and ligamentous injuries to the ankle are also seen in ground falls. Standard orthopedic guidelines suggest operative repair for displaced fractures as well as calcaneus or talus fractures in young, active patients.
A case of posttraumatic osteochondritis dissecans with a large osseus defect at the medial talar shoulder was discussed. This patient had failed a drill-hole arthroscopic procedure and subsequently had success with an osteograft with cartilage transplant. Three cases of peroneal tendon dislocation that underwent successful surgical management were also described.
Climbing foot injuries result from wearing climbing shoes that are unnaturally shaped or too small. Common problems are callosity, nail bed infections, pressure marks, neurologic complaints, claw toes, blisters, and subungual hematomas. A long-term problem is the development of a hallux valgus deformity. Climbers should be counseled not to wear extremely tight shoes, and future climbing shoes should adjust the biomechanical forces on the foot to prevent these problems. Limitations of this article include discrepancies in the existing literature on the incidence of lower extremity injuries in climbers.
(World J Orthop. 2013;4:218–228). V Schöffl, T Küpper.