While there has been a lot of talk recently of the increase in head injuries in the sport, specialists at the hospital say they have discovered a specific type of hip fracture in teenage rugby players more usually associated with violent trauma. Their medical research has led them to call for rule changes in order to prevent “potentially devastating consequences”.
The study, (which can be read here) appears in the latest issue of the British Medical Journal Case Reports, and was carried out by doctors from the Department of Trauma and Orthopaedics at Tallaght Hospital. The doctors focused on three cases where players aged between 13 and 16 were seriously injured when tackled. Two other cases were studied previously. Their findings also coincide with the publication last week of an open letter from more than 70 doctors, health experts and academics to the UK government, calling for a ban on tackling in school rugby.
The types of injuries were uncommon ones known as “acetabular fractures (which) “affect the socket of the hip bone, and are generally sustained after violent trauma, such as road traffic accidents” the doctors write. The report goes on to say:
“We have not previously encountered these injuries in a juvenile sporting population and it is possible that a change in emphasis may have increased the potential for such injuries to occur.
“Many schools and juvenile rugby clubs have adopted a more professional attitude towards the game, with a significant emphasis being placed on weight training and physical size.
“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 that while young players facing each other may be of the same age, differences in size and bone age may be “magnified” during tackles and rucks, as players who are physically more mature engage with less mature counterparts.
Dr David Morrissey, one of the authors of the research, said he disagreed with the recent call for a ban on tackling at school level. Instead, he emphasised the benefits of sport and said he favoured “subtle changes”.
“I think that sport, from a physical, social and psychological viewpoint, is hugely important. Lots of people enjoy rugby, and contact is part of it,” he said, adding that he and his colleagues would recommend the UK following the example of New Zealand where young players are classified by size, rather than age.
“It would probably be better to have players weighted, and in addition I think it would also help skill level. My worry would be that if you instituted a no-tackling policy at junior level then when you come to adult rugby you may be without that tackling skill and have problems as a result.”
Morrissey and his colleagues noted that the physical profile of rugby players, their training and injury patterns had changed significantly since the introduction of professionalism in 1995. Such changes had permeated to all levels of play, including at school.
Rule changes which had increase the length of time in which the ball was in play had also increased the exposure to potential injury.
Two of the injuries studied occurred during seasonal match play and the other during a training drill. They followed pressure exerted through a flexed hip with the knee on the ground, a position that can be encountered during a two-man tackle, as one tackler hits low and the other hits high. All of the young players recovered after surgery and rehabilitation.