Trenutni pristopi zdravljenja športno plezalnih poškodb krožnih vezi prstov na roki - pregled literature : diplomsko delo

Mali, Katra (author), Hlebš, Sonja (mentor), Hiti, Nina (reviewer)

Uvod: Popularnost športnega plezanja se drastično veča. Posledično se povečujejo tudi poškodbe, nastale med plezanjem, s tem pa tudi potreba fizioterapevtov in drugih zdravstvenih delavcev po boljšem razumevanju možnih pristopov zdravljenja teh poškodb. Ena izmed najbolj tipičnih plezalnih poškodb je poškodba krožne vezi prsta. Krožne vezi preprečujejo fleksornim kitam, da bi zapustile svoje anatomsko mesto. Pri plezanju so pomembne pri držanju majhnih oprimkov, za kar so potrebne velike sile fleksornih mišic prstov, ki se prenašajo na krožne vezi. Najpogosteje pride do poškodbe v položaju maksimalne fleksije proksimalnega interfalangealnega sklepa (90–100°) ter hiperekstenziji distalnega interfalangealnega sklepa. Najpogosteje do poškodbe pride na prstancu, takoj zatem pa na sredincu. Glede na značilnosti poškodbe vezi se jih deli na različne stopnje, ki jim je prilagojeno tudi zdravljenje. To je lahko konzervativno ali kirurško. Namen: Namen diplomskega dela je bil na podlagi pregleda literature analizirati trenutne pristope zdravljenja poškodbe krožnih vezi pri plezalcih. Metode dela: Metode dela vključujejo pregled podatkovne baze PubMed ter Science Direct ob uporabi ključnih besed finger pulley injury AND flexor pulley injury AND current concepts. Za analizo so bile uporabljene raziskave v angleškem jeziku, objavljene po letu 2015. Rezultati: Analizirali smo 5 raziskav. Rezultati so pokazali, da so konzervativni pristopi zdravljenja, ki vključujejo uporabo stabilizacijske ortoze, običajno prednostna izbira, zlasti v akutni fazi, saj pomaga ohranjati kito blizu falange. Takojšnja vrnitev k plezanju ob uporabi ortoze je učinkovita, medtem ko je kirurški poseg predviden za hujše primere, kot so večkratna pretrganja vezi ali neuspeh konzervativnih pristopov zdravljenja. H-povijanje poškodovane krožne vezi ne preprečuje poškodb ali poveča moči, lahko pa ima psihološki učinek. Ugotovljeno je bilo, da hitrejši začetek zdravljenja vodi do boljših rezultatov, večina plezalcev se z ustreznim pristopom vrne na raven plezanja pred poškodbo. Razprava in zaključek: Izsledki raziskav so pokazali, da je pri nižjih stopnjah poškodbe krožne vezi priporočljivo nadaljevanje s plezanjem ter uporaba ortoze. Težja kot je poškodba, bolj se svetuje imobilizacija in pri hudih poškodbah kirurška obravnava. Kljub obetavnim rezultatom rehabilitacije raziskave opozarjajo na omejitve, kot so majhni vzorci preiskovancev in pomanjkanje kontrolnih skupin

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, krožne vezi, zdravljenje, poškodba krožne vezi
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [K. Mali]
• Year: 2025
• Number of pages: 28 str.
• PID: 20.500.12556/RUL-168568
• UDC: 615.8
• COBISS.SI-ID: 233219587
• Publication date in RUL: 17.04.2025

Secondary language

• Language: English
• Title: Current concepts on treatment finger pulley injuries in rock climbers - literature review : diploma work

Abstract

Introduction: The popularity of sport climbing is increasing dramatically. As a result, climbing injuries are increasing and with them the need for physiotherapists and other healthcare professionals to better understand the possible approaches to treating these injuries. One of the typical injuries in climbing is the injury to the annular ligament of the finger, the pulley injury. The role of the annular ligaments is to prevent the flexor tendons from leaving their anatomical location. They are important for holding small grips that require large forces from the flexor muscles of the fingers, which are transferred to the annular ligaments. The most common injury occurs in the position of maximum flexion at the proximal interphalangeal joint (90-100°) and hyperextension of the distal interphalangeal joint most frequently on the ring finger, followed by the middle finger. Depending on the characteristics of the ligament injury, they are categorised into different stages, which are also related to the treatment, which can be conservative or surgical. Purpose: The aim of this article is to analyse the current approaches to the treatment of ring ligament injuries in climbers using a literature review. Methods: The literature search was conducted in the PubMed and Science Direct databases using the keywords finger pulley AND flexor pulley injury AND current concepts published after 2015. Results: We analysed five studies. The results show that conservative treatment, including the use of an orthosis to protect the pulley, is usually the preferred choice, especially in the acute phase, as it helps to keep the tendon close to the phalanx. Immediate return to climbing with an orthosis is effective, while surgical intervention is reserved for more severe cases, such as multiple pulley tears or failure of conservative treatment. H-taping does not prevent injury or increase strength, but it can have a psychological benefit. It has been shown that starting treatment earlier leads to better results and that most climbers return to their previous climbing level with an appropriate approach. Discussion and conclusion: The results of the analysed studies indicate that it is advisable to continue climbing with an orthosis for minor pulley injuries. The more severe the injury, the immobilisation is recommended, and for severe injuries, the surgical treatment. Despite the promising rehabilitation results, the studies point to limitations such as small sample sizes and the lack of control group.

• Keywords: diploma theses, physiotherapy, annular ligaments, treatment, pulley injury