Title : A retrospective observational study of rock-climbing injuries in Singapore
Abstract:
Rock climbing is gaining popularity in Singapore resulting in an increasing number of rock-climbing associated injuries requiring surgery. The sport encompasses multiple disciplines including, but not limited to top rope climbing and bouldering. Top rope climbing involves ascending a route with safety rope attachment from above, minimalizing falls when rock grip is lost. Bouldering encompasses moves that are generally powerful in nature and low to the ground. Most climbers use a crash pad for protection in the event of a fall. With a variety of disciplines, injuries vary widely from head to toe due to an array of mechanism of injuries ranging from chronic overuse, to acute atraumatic injuries from supraphysiologic loading, to acute traumatic injuries from fall from height or rockfall. The main objective of this study is to evaluate the demographics, mechanism, type and extent of injuries in patients admitted following rock climbing-related injuries over a 7-year period in Singapore. All patients admitted to the Department of Orthopedic Surgery between January 2017 to December 2023 with injuries related to rock climbing accidents were recruited. Data collection was performed retrospectively on the type of rock climbing, patient profile, day and time of injury, mechanism and types of injury and outcomes. Patient demographics such as age, gender and body mass index (BMI) were considered. The type and extent of injuries were identified based on the number and site of injuries, open or closed fractures and the need for surgical management. The need for a subsequent surgery was also considered. 22 patients were included in this study. 73.7% of the accidents occurred in the afternoon, equally distributed across the week. In terms of patient profile, most of them were young adults (mean age 27.32), female (77.3%) with a mean BMI of 23.67 kg/m2. 90.9% of them fell from height of average 2.95m and maximum of 10m. 95.9% of patients sustained fractures with 23.8% having more than 1 fracture, 90.9% requiring surgery and 31.8% requiring a second surgery. Patients who fell from a higher height were more likely to sustain multiple injuries (p=0.012) and open fractures (p=0.013). Lower limb injuries (72.7%) were more common than upper limb (18.2%) and spine (22.7%) injuries. Incidence of injuries from top-rope climbing (54.5%) and bouldering (45.5%) were relatively similar. There were significantly more females injured from bouldering than top-rope climbing (p=0.009). In top-rope climbing, multiple injuries were more common (p=0.019) with a higher incidence of upper limb injuries (p=0.019) comparative to bouldering. Acute traumatic rock-climbing associated orthopedic injuries are common with increasing popularity amongst young adults, and can occur equally in top-rope climbing and bouldering. They are predominantly caused by falls, commonly resulting in fractures requiring surgical intervention and especially affecting the lower extremities. Proper safety precautions, equipment, and training specific to the various disciplines of rock climbing should be observed by all climbers in order to help decrease the rising trend of rock climbing-related injuries in Singapore.
What will audience learn from your presentation?
- Majority of acute rock-climbing orthopedic related injuries occur due to fall from height with a higher likelihood of having multiple injuries or open fractures with a higher fall height. This emphasizes the importance on having proper safety precautions and equipment specific to the various disciplines.
- Majority of those injured are females, of which majority of them from bouldering than top-rope climbing. Comparing the two, bouldering focuses more on power and technique while top-rope climbing focuses more on endurance. With this, it may be beneficial for first time climbers, especially females with understandably lower power than males, to start off with top-rope climbing and proceed to bouldering after there is sufficient training done to lower the risk of injuries.
