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Distal Radial Growth Plate Injury and Positive Ulnar Variance in Nonelite Gymnasts

Department of Family Medicine, University of California, Los Angeles

James C. Puffer, MD

Department of Family Medicine, University of California, Los Angeles

Bert R. Mandelbaum, MD

Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, California

Frederick Dorey

Department of Orthopaedic Surgery, University of California, Los Angeles

To assess the prevalence of stress injury to the distal radial growth plate and of positive ulnar variance in a nonelite gymnast population, we administered a radio graphic survey and questionnaire to 44 skeletally im mature nonelite gymnasts (27 girls and 17 boys). The subjects trained an average of 11.9 hours per week. Radiographic findings consistent with stress injury of the distal radial physis were found in 25% (11 of 44) of participants. Ulnar variance was found to be more positive in the gymnasts when compared with age- predicted norms. An average side-to-side difference in ulnar variance of 0.9 mm was observed. Radiographic findings of stress injury to the growth plate and the amount of ulnar variance were not associated with age, sex, training intensity, wrist pain, height, or weight. There was also no significant relationship between ulnar variance and radiographic findings. The mean ulnar variance in nonelite gymnasts was between that measured for elite gymnasts and nongymnasts. These results indicate that stress injury of the distal radial growth plate occurs in a significant percentage of non elite gymnasts. It also appears that ulnar variance is more positive than would otherwise be predicted, sug gesting growth inhibition of the distal radius, a growth stimulation of the ulna, or a combination of both.

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