A Retrospective Observational Study of Rock-Climbing Injuries in Singapore

Background Rock climbing is becoming increasingly popular in Singapore resulting in an increasing number of rock-climbing-associated injuries requiring surgery. The main objective of this study is to evaluate the demographics, mechanism, and extent of injuries in patients admitted following rock-climbing-related injuries over a seven-year period. Method All patients admitted to the Department of Orthopedic Surgery between January 2017 and December 2023 with injuries related to rock-climbing accidents were recruited. Data collection was performed retrospectively on the patient profile, day and time of injury, type of rock climbing, mechanism, pattern, and the extent of injury. Results Across 22 patients, 68.4% of injuries occurred in the afternoon, distributed equally across the week. Demographically, majority were young adults (27.3 + 7.8 years), female (77.3%) with a mean BMI of 23.67 + 3.27 kg/m². A total of 90.9% of them fell from height commonly resulting in fractures (95.5%), of which 54.5% sustained two or more fractures and 9.5% sustained open fractures. Comparatively, falling from a higher height resulted in multiple injuries, though not statistically significant. The two patients who sustained open fractures fell from a height of 2 m and 10 m. Lower limb injuries (72.7%) were more common than upper limb (18.2%) and spine (22.7%) injuries. A total of 90.9% of them required surgery, of which 36.8% required a second surgery. A relatively equal number of injuries were sustained from bouldering (45.5%) and sport climbing (54.5%). Females were shown to be more likely injured from bouldering than sport climbing (p = 0.040). A total of 100% of bouldering injuries occurred due to falls from height, while 16.7% of injuries during sport climbing were due to laceration or hand-hold injury. Patients who fell from sport climbing fell from a higher height of 3.35 + 2.6 m compared to bouldering at 2.5 + 0.9 m. Moreover, 33.3% of patients injured from sport climbing sustained multiple regions of injuries, two of which were open fractures, while all injured from bouldering only sustained injuries in a single region, only sustained closed fractures, and none affected the upper extremity. A total of 100% of bouldering injures and 80% of sport-climbing injuries required surgery where around 37% of patients in both groups required repeat surgery. Patients with sport-climbing injuries had a longer length of hospital stay (13.8 + 18.3 days) and duration of hospitalization leave (dHL) (81.3 + 45.5 days) compared to bouldering injuries. Conclusion Rock-climbing-associated injuries are predominantly caused by falls, commonly resulting in fractures requiring admission and surgical intervention, especially in the lower extremities. With increasing popularity and accessibility of the sport in Singapore, there is an expected increase in the number of orthopedic injuries. Injuries vary widely from lacerations to fractures of the extremities and spine to open fractures requiring emergency surgery. Proper safety precautions, equipment, training, and strict regulations for belay certification should be put in place to mitigate the risk of such injuries.