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General Orthopaedics

Serious neck injuries in schoolboy rugby - an audit of admissions to spinal injury units in the United Kingdom and Ireland

British Orthopaedic Association/Irish Orthopaedic Association Annual Congress (BOA/IOA)



Abstract

Introduction

Catastrophic neck injury is rare in rugby, however the consequences are invariably devastating. Schoolboys have previously been identified as a group at risk. This study came about as a result of a recent increase in admissions of schoolboy rugby players to the National spinal injuries unit in Glasgow.

Aim

To audit schoolboy rugby admissions to spinal injury units throughout the United Kingdom and Ireland, in doing so to appraise the current state of data collection. To obtain estimates of playing numbers from the Home unions.

Method

Retrospective review of all 12 spinal injury units for records of cases subsequent to 1996. Representatives of each of the four home unions were contacted to confirm cases and establish playing numbers.

Results

Records were available from 1996 in Scotland and Ireland and from 2000 in England and Wales. Two units collect prospective data, two had easily retrievable data. In the absence of any register data retrieval was challenging elsewhere.

Of the 36 cases 24 would be classified as catastrophic 12 as near misses.

The median age for injury was 17.

51% of injuries occurred in the tackle, 35% in the scrum. 92% of scrum injuries involved neurological damage, 61% with complete neurological loss at presentation, 8% with no neurological injury. Tackle injuries were associated with neurological damage in 42%, 26% with complete lesions and no neurological injury in 57%.

Estimates for playing numbers (U18 inclusive) approximate to Scotland 19,000, Wales 30,000, Ireland 40,000 and England 1,200,00.

Conclusion

  1. A persistent number of schoolboys were injured through the study period.

  2. Recording of serious neck injuries is inconsistent through the United Kingdom and Ireland.

  3. The numbers injured in Scotland were disproportionate in view of the relative playing populations.

  4. Whilst less frequent, scrum injuries were more often associated with spinal cord injury