Concern over new injury in young rugby players

Type of hip fracture associated with violent trauma found in players at Tallaght hospital

In all cases the injuries occurred during the tackle phase of play. Photograph: Thinkstock/Getty Images
In all cases the injuries occurred during the tackle phase of play. Photograph: Thinkstock/Getty Images

Specialists at Tallaght hospital in Dublin have identified a new type of injury in teenage rugby players. The discovery of a specific type of hip fracture, more usually associated with violent trauma, will add to growing concern about the game’s injury risks, particularly for younger players.

Writing in the medical journal BMJ Case Reports, orthopaedic surgeons at the hospital describe four cases of acetabular fracture of the hip in three young rugby players.

“We have not previously encountered these injuries in a juvenile sporting population” they say in research published this morning.

In all cases the injuries occurred during the tackle phase of play. The authors say they were the direct result of pressure exerted through a flexed hip with a knee on the ground. This position can be encountered during a two-man tackle, as one tackler hits low and the other hits high.

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As well as being fractured, the hips are also likely to dislocate. Dr David Morrissey and his co-authors also point out that further exposure to risk may occur during the ruck phase of play where the bridging player stands while bending over the ball.

Although all three boys, who were aged between 13 and 16, described in the case series recovered following surgery and rehabilitation, the authors warn of the potentially devastating impact on growth, sporting participation and lifestyle of such injuries.

“In order to prevent the potentially devastating consequences of these injuries it may be necessary to implement rule changes or size restrictions in the juvenile game,” the doctors write.

Players may be of the same age, but can be different sizes, they point out. This is associated with an increased injury risk, they note, adding to the problems linked with excessive force in an immature skeleton.

“An evaluation of the rules at the breakdown and an emphasis on proper tackling could aid injury prevention,” they conclude.

Muiris Houston

Dr Muiris Houston

Dr Muiris Houston is medical journalist, health analyst and Irish Times contributor