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What is Distal Radius Physis Stress Syndrome?

Distal Radius Physis Stress Syndrome is a childhood and adolescent condition in which the growth plate located at the end of the radius next to the wrist is repeatedly overloaded—usually by training for competitive sports such as gymnastics.

It is a chronic overuse injury primarily affecting young gymnasts, which is why it is often called “gymnast’s wrist.”

Signs and Symptoms of Distal Radius Physis Stress Syndrome?

Pain on the thumb side of the wrist is the most common symptom and should be treated with rest and temporary immobilization so that the injury does not result in more serious compromise of the growth plate that could lead to permanent bony deformity. Pain may be intermittent and ongoing, which may be aggravated by weight-bearing and wrist impact activities. Initially, pain may only occur during gymnastics progressing into regular activities and finally, during rest.

Some of the most commonly reported symptoms include:

  • Radial sided (thumb) wrist pain
  • Swelling in wrist
  • Tenderness to palpation at the distal radius
  • Decreased wrist flexion or extension

Causes of Distal Radius Physis Stress Syndrome

Because the wrist undergoes supraphysiological loads from use as a weight-bearing joint during gymnastics, repetitive stress causes inflammation at the growth plate of the distal radius. Microtrauma can lead to premature closure of the distal radial physis, which has the potential to result in secondary overgrowth of the ulna.

Injuries Associated with Distal Radius Physis Stress Syndrome

Though this injury is often associated with gymnasts over a period of increased intensity and activity, other impact activities like vaulting and tumbling place compressive force on the growth plate of the wrist.

These repetitive stress injuries lead to inflammation and damage to the growth plate, making it even more imperative to get proper treatment as soon as possible.

Other disorders associated with distal radius physis stress syndrome include:

  • Distal ulnar overgrowth
  • Distal radioulnar joint instability

Treatment Options for Distal Radius Physis Stress Syndrome

Evaluation of this condition will include a physical examination for tenderness, loss of motion, and swelling. X-rays are useful for evaluating irregularities of the growth plate, such as widening or signs of premature growth plate closure. MRI can be employed.

Treatments for this injury typically require activity modification, such as ceasing all weight-bearing activity on the hand.

Conservative Treatments

Initial treatment is focused on rest until the pain resolves, which may take a couple of months. Immobilization, splints, ice, and anti-inflammatory medications can be helpful in reducing pain and inflammation.

Young gymnasts ought to be splinted or braced and understand the importance of their problem and its treatment.  

Surgical Treatments

Surgical intervention is not often required for injuries of this nature unless conservative methods have failed to provide relief. In such cases, surgical intervention may be required to remove the bony bar causing abnormal radius growth in the wrist on the thumb side. Altering ulna growth is a possibility to help restore a level wrist.

Patients or their parents ought to consult a medical professional at the first sign of pain and inflammation following load-bearing activities to the hand and wrist.

Prognosis for Distal Radius Physis Stress Syndrome

After pain and inflammation have been resolved, patients may return to supervised activities gradually. Patients are advised to cease irritating activities and see a specialized hand surgeon for further evaluation if pain continues.

Healing times vary widely depending on the severity of the injury.

If You Believe You Have Distal Radius Physis Stress Syndrome, Contact HandSport Surgery Institute

Please contact us as soon as possible to schedule an appointment with our talented team. People experiencing Distal Radius Physis Stress Syndrome should be evaluated to try and prevent further injury and mobility issues. If you have been injured, it’s important to be evaluated by a highly skilled professional.

Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment, obtain an accurate diagnosis, and start to restore comfort to your hand.

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