{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:56:43Z","timestamp":1790855803406,"version":"4.1.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[1992,5,1]],"date-time":"1992-05-01T00:00:00Z","timestamp":704678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[1992,5]]},"abstract":"<jats:p>We conducted a radiographic survey to determine skel etal age and the nature and prevalence of stress-related changes affecting the distal radial growth plate in 60 young competitive gymnasts (39 females, 21 males). Comparison of results for chronological and skeletal age revealed a significant delay in maturation for girls (P &lt; 0.001). Radiographic evaluation revealed 5 gym nasts (4 girls and 1 boy) with stress-related changes of the left wrist, and four of these were considered to be minimal.<\/jats:p>\n                  <jats:p>These results, in conjunction with our previous find ings and the review of related literature, reveal three important observations. First, the widening and irregu larities of the distal radial physis that we described previously appear to be the first in a spectrum of abnormal changes secondary to overuse and probably represent a stress fracture of the distal radial growth plate. The radiographic changes associated with this injury are not the normal adaptive changes seen in young, competitive gymnasts.<\/jats:p>\n                  <jats:p>Secondly, more serious long-term abnormality may result even though the injury may initially resemble a Salter-Harris type I or II stress fracture. Long-term complications may include symmetrical or asymmetrical retardation or halted growth at the affected site, posi tive ulnar variance, and associated pathoanatomic se quelae. Thirdly, the incidence of distal radial growth plate stress injury remains unclear; we recommend a further, large-scale prospective epidemiologic study in volving both male and female gymnasts. We urge that physicians and other health professionals associated with gymnastics clubs educate coaches about the pos sibility of significant injury to the distal radial physis, risk factors, and suggested preventive measures.<\/jats:p>","DOI":"10.1177\/036354659202000310","type":"journal-article","created":{"date-parts":[[2007,6,21]],"date-time":"2007-06-21T20:46:52Z","timestamp":1182458812000},"page":"290-298","source":"Crossref","is-referenced-by-count":100,"title":["Stress changes of the distal radial growth plate"],"prefix":"10.1177","volume":"20","author":[{"given":"Dennis","family":"Caine","sequence":"first","affiliation":[{"name":"Department of Exercise and Movement Science, University of Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Roy","sequence":"additional","affiliation":[{"name":"Sports Injury Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth M.","family":"Singer","sequence":"additional","affiliation":[{"name":"Orthopedic and Fracture Clinic, Eugene, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Broekhoff","sequence":"additional","affiliation":[{"name":"Department of Exercise and Movement Science, University of Oregon, Sports Injury Clinic, Orthopedic and Fracture Clinic, Eugene, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1992,5,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198901000-00005"},{"key":"atypb2","unstructured":"Aldridge MJ: Overuse injuries of the distal radial growth epiphysis, in Hoshizaki TB, Salmela JH , Petiot B (eds): Diagnostics, Treatment, and Analysis of Gymnastic Talent. Montreal, Sport Psyche Editions, 1987"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1007\/BF00347411"},{"key":"atypb4","unstructured":"Auberge T., Zenny JC, Duvallet A., et al: Etude de la Maturation Osseuse et des L\u00e9sions Ost\u00e9oarticulaires des Sportifs de Haut Niveau. J Radiol ( Paris) 65: 555-561, 1984"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198971080-00016"},{"key":"atypb6","unstructured":"Bayer IM, Bayley N.: Growth Diagnosis. Second edition. Chicago, University of Chicago Press, 1976"},{"key":"atypb7","doi-asserted-by":"crossref","unstructured":"Bright RW, Burstein AH, Elmore SM: Epiphyseal-plate cartilage: A biomechanical and histological analysis of failure modes. J Bone Joint Surg 65A: 688-703, 1974","DOI":"10.2106\/00004623-197456040-00004"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1080\/03014467700002441"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1123\/pes.2.3.209"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.1987.11709303"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1177\/036354658901700616"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.1985.11708857"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-61-722-109"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.70B5.3192589"},{"key":"atypb15","unstructured":"Fliegel CP: Stress related widening of the radial growth plate in adolescents . Ann Radiol (Paris) 29: 374-376, 1986"},{"key":"atypb16","doi-asserted-by":"crossref","unstructured":"Gelberman RH , Salamon PB, Jurist JM, et al: Ulnar variance in Kienbock's disease . J Bone Joint Surg 57A: 674-676, 1975","DOI":"10.2106\/00004623-197557050-00017"},{"key":"atypb17","doi-asserted-by":"crossref","unstructured":". Greulich Ww , Pyle Si: The Radiographic Atlas of Skeletal Development of the Hand and Wrist. London, Oxford University Press, 1959","DOI":"10.1097\/00000441-195909000-00030"},{"key":"atypb18","doi-asserted-by":"crossref","unstructured":". LeVeau Bf , Bernhardt Db: Developmental Biomechanics. Effects of forces on the growth, development, and maintenance of the human body. Phys Ther 64: 1874-1882, 1984","DOI":"10.1093\/ptj\/64.12.1874"},{"key":"atypb19","unstructured":"Lindner K., Caine D.: Injury patterns of female competitive club gymnasts. Can J Sport Science 15: 254-261, 1990"},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(20)31431-9"},{"key":"atypb21","unstructured":"Malina RM: Biological maturity status of young athletes, in Malina RM, (ed): Young Athletes-Biological, Psychological, and Educational Perspectives. Champaign, IL, Human Kinetics Publishers, 1988"},{"key":"atypb22","unstructured":"Mandelbaum BR: Gymnastics, in Reider B (ed): Sports Medicine\u2014The School-Age Athlete. Philadelphia , WB Saunders, 1991"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1177\/036354658901700301"},{"key":"atypb24","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.1988.11709406"},{"key":"atypb25","doi-asserted-by":"publisher","DOI":"10.1177\/036354658701500607"},{"key":"atypb26","doi-asserted-by":"publisher","DOI":"10.1249\/00003677-198600140-00015"},{"key":"atypb27","unstructured":"Ogden JA: Skeletal Injury in the Child. Philadelphia, Lea & Febiger, 1982"},{"key":"atypb28","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197204000-00002"},{"key":"atypb29","doi-asserted-by":"crossref","unstructured":"Powell K., Koho HW, Caspersen CJ, et al: An epidemiological perspective on the causes of running injuries . Physician Sportsmed 14 (6): 111-114, 1986","DOI":"10.1080\/00913847.1986.11709103"},{"key":"atypb30","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.15.4.272"},{"key":"atypb31","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.8.2.3363192"},{"key":"atypb32","doi-asserted-by":"publisher","DOI":"10.1177\/036354658501300503"},{"key":"atypb33","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-199104000-00001"},{"key":"atypb34","unstructured":"Salmela JH: Growth patterns of elite French Canadian female gymnasts. Can J Appl Sport Sci 4: 219-222, 1979"},{"key":"atypb35","unstructured":"Sands B., Eisenman P., Johnson S., et al. Getting ready for 1988: Research and athlete preparations project-Junior Elite female gymnasts. Technique 87: 12-18, 1987"},{"key":"atypb36","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.1984.11701896"},{"key":"atypb37","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.1985.11708833"},{"key":"atypb38","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1025810"},{"key":"atypb39","unstructured":"Tanner JM: Fetus in Man: Physical Growth from Conception to Maturity. Cambridge, MA, Harvard University Press , 1978"},{"key":"atypb40","doi-asserted-by":"publisher","DOI":"10.1016\/0363-5023(88)90192-X"},{"key":"atypb41","doi-asserted-by":"crossref","unstructured":"Walter SD, Hart LE: Application of epidemiological methodology to sports and exercise science research. Exerc Sport Sci Rev 18: 417-448, 1990","DOI":"10.1249\/00003677-199001000-00017"},{"key":"atypb42","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198870070-00019"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/036354659202000310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/036354659202000310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:37:33Z","timestamp":1777369053000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/036354659202000310"}},"subtitle":["A radiographic survey and review of the literature"],"short-title":[],"issued":{"date-parts":[[1992,5]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1992,5]]}},"alternative-id":["10.1177\/036354659202000310"],"URL":"https:\/\/doi.org\/10.1177\/036354659202000310","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[1992,5]]}}}