More Serious Hip Injuries in Young Rugby Players Interview with:
David Morrissey MB PhD FRCS (Tr&Orth)
Orthopaedic Specialist Registrar What is the background for this study? What are the main findings?

Dr. Morrissey: Injury rates in rugby union have increased substantially over the past twenty years, both in the professional and amateur game. The pattern of injury has also changed, reflecting higher grades of trauma. Our institution is a tertiary referral centre for pelvic and acetabular trauma serving a population of 4.5 million. The majority of our cases occur as a result of high velocity trauma such as road traffic accidents. We have not previously seen hip dislocations/acetabular fractures occurring secondary to sporting participation. In the past number of years, however, we have identified four such injuries in three juvenile patients, that occurred during rugby union participation. These injury patterns may have sub-optimal outcomes in up to 30% of patients and can severely affect a young person’s life. The demographic change may be due to changes in the physical development of players as well as an increased emphasis on the tackle/ruck area. In the juvenile game, differing rates of maturation magnify size differences between players, potentially increasing the risk of injury. What should clinicians and patients take away from your report?

Dr. Morrissey: Physicians should be aware that these injuries occur, as should coaches, parents and the players themselves. The article is also of relevance to the governing bodies of the sport. It, along with numerous other reports should prompt a reevaluation of the factors involved in the changing patterns of injury seen in the modern game. What recommendations do you have for future research as a result of this study?

Dr. Morrissey: It would be interesting to establish which body positions leave the player vulnerable to these injuries. This may be possible to assess with anatomic specimens tested in a biomechanics lab or using computer models. Once this was established, rule changes could focus on avoidance of these positions. Is there anything else you would like to add?

Dr. Morrissey: Injuries are inherent in sporting activity, particularly in contact sports such as rugby. The psychological and physical benefits of participating in sport are huge, but player safety should be paramount. It is worrying that these injuries, previously seen following high energy trauma such as motor vehicle accidents, are now occurring more frequently following participation in rugby. Recently, there have been calls for a tackle ban to be instituted in juvenile rugby. It is likely, however, that this would detract from an element of the game many people enjoy. In addition, it will likely lead to players having poor tackle technique once they graduate to an adult grade, potentially increasing their injury risk at that level. Rule changes need not be seismic, but do need to be considered to decrease the risk of serious injury to juvenile players, whilst maintaining the spirit and egos of the game. Thank you for your contribution to the community.


 Acetabular fractures in skeletally immature rugby players

David I Morrissey, Daniel Good, Michael Leonard

BMJ Case Reports 2016:published online 7 March 2016, doi:10.1136/bcr-2015-211637

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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David Morrissey MB PhD FRCS (2016). More Serious Hip Injuries in Young Rugby Players 


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