Left hand of 15-year-old male climber who undertook intensive finger strength exercises and ignored medical advice, permanently damaging epiphyseal plate of proximal interphalageal joint in middle finger. Informed consent obtained for publication. (Reproduced from: Hochholzer T, Schöffl V. Epiphyseal fractures of the finger middle joints in young sport climbers. Wilderness Environ Med 2005;16:4-7, with permission from the Wilderness Medical Society). 22