Physeal Stress Injuries of the Hand/Fingers

Primary periphyseal stress injuries (PPSIs) to the hand and fingers are rare, and most are reported as digital physeal stress injuries to the fingers among adolescent rock climbers. There are over 200 cases, and lately therapeutic and diagnostic guidelines have been published. Early diagnosis is important for a good outcome, and most of these injuries can be treated conservatively. Only those cases that show no tendency to fuse or contain superimposed dislocated fracture require surgery. Other stress-related injuries to the hand and fingers include Kienböck’s, Dietrich’s, and Thiemann’s disease. These tend to occur infrequently, and only small case series have been published in the literature. Therapy is mostly conservative, only certain stages of the conditions require a surgical procedure.