Epidemiology of rugby-related fractures in high school- and college-aged players in the United States: an analysis of the 1999–2018 NEISS database

ABSTRACT

Objectives

Rugby is a high-impact collision sport with identical competition rules by sex. The aim of this study was to analyze the trend of rugby-related fractures by body site, sex, and age in amateur athletes from 1999 to 2018.

Methods

The National Electronic Injury Surveillance System (NEISS) database was queried to characterize rugby-related injuries from 1999 to 2018 in patients aged 14–23 years old. National injury estimates were calculated using sample weights. Chi-square analysis and one-way ANOVA were performed to compare categorical variables.

Results

Out of a total of 43,722 weighted cases of rugby-related fractures over the 19-year period, 70.9% were among high school- and college-aged males and females between the ages of 14–23 years (N = 30,996). Males constituted 79.3% of cases whereas females composed 20.7% of the cases. The proportion of upper extremity fractures was similar in both males and females, yet facial fractures were significantly more common among males than females (27.9% vs. 14.6%, P < 0.001). Among facial fractures, nasal fractures represented 74.4% of the sample, yet facial fractures only resulted in hospital admittance in 1.3% of cases. Lower extremity fractures were more likely to be severe, with 11.3% of LE cases being admitted to the hospital.

Conclusion

Rugby players in the US diagnosed in the ED with fractures consisted largely of male, high school- and college-aged athletes. Males and females experienced upper and lower-extremity fractures at comparable rates, yet lower extremity injuries were more likely to be admitted to a hospital. Men were significantly more likely to experience a facial fracture in which a majority were nasal fractures.

KEYWORDS:

• Rugby
• fracture
• emergency department
• epidemiology

Declaration of interest

Dr Brett Owens is a consultant for Mitek, Conmed, Vericel, and Miach and receives royalties from Conmed. He has stock options with Vivorte and receives research support from Arthrex, Mitek, and MTF. No other authors have any disclosures.