Femoral neck stress fracture during sport climbing

Thomas Küpper; Steven Rutten; Audry Morrison; Volker Schöffl

doi:10.5604/01.3001.0015.5750

Authors

Thomas Küpper Institute of Occupational and Social Medicine, RWTH Technical University, Aachen, Germany; Medical Commission of the International Climbing and Mountaineering Federation (UIAA MedCom), Bern, Switzerland
Steven Rutten Therapeuticum Aachen-Laurensberg, Aachen, Germany
Audry Morrison Royal Free London NHS Foundation Trust, London, United Kingdom; Medical Commission of the International Climbing and Mountaineering Federation (UIAA MedCom), Bern, Switzerland
Volker Schöffl Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Germany; Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Germany; Royal Free London NHS Foundation Trust, London, United Kingdom

DOI:

https://doi.org/10.5604/01.3001.0015.5750

Keywords:

sport climbing, injury, diagnosis, rehabilitation, physiotherapy, occult fracture

Abstract

While the epiphyseal stress fracture of the finger’s middle phalanx is a known sport-specific injury occurring only in adolescent climbers, and in other locations it’s rare, no femoral neck stress fracture (FNSF) in sports climbing has yet been reported. An experienced female sport climber (37y, 160 cm, 45 kg, BMI 17.5) suffered from pain in the left inguinal region while climbing, and later, also required a stick to walk. Routine radiography missed the FNSF and it was many weeks before a MRI accurately provided that diagnosis. The time between the X-ray and MRI should have been minimized as it resulted in a delayed diagnosis, unnecessary pain and delayed healing. In this situation the initial clinical investigation, the patient’s history and the X-ray did not lead to a clear diagnosis, and the initial treatment was ineffective. Further investigation by MRI and / or CT scans should have taken place sooner and would have been essential.

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