Referral of professional Rugby League players to the orthopaedic service: A review of 447 injuries in 147 players

A review of 447 separate injuries or clinical conditions affecting 147 professional or high-class rugby players was performed. These were moderate or severe injuries as referred to a consultant orthopaedic surgeon. Most were referred by the club doctor (50.1%) or physiotherapist (46.3%). The relative risk of injury of each player position was calculated and no significant difference in frequency of injury was found. There was a predominance of lower limb injuries (46.1%) and knee injuries had the highest frequency of any regional group (27.1%). Upper limb injuries made up 27.3% of injuries, lumbar and cervical spine injuries 14.8%. There was no excess of injuries in the younger inexperienced players or in the older players with their possibility of more cumulative injuries. A worrying number of degenerative conditions were diagnosed (14.7%); there was no excess in any age group. Ligamentous injuries and fractures were the most common injury categories (26.7% and 17.5%), the fracture patterns are analysed in more detail. A large number of the consultations led to an operative procedure (187 of 447; 41.8%). The average time for players out of the game through injury was 1.8 months. Five players were out of the game for more than one year; fifteen players never returned to to play: their injuries are more clearly detailed.