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Adolescent Shoulder Injuries in Rugby

Authors: G Hodhody, T Mackenzie, L Funk

References: ESSKA, Amsterdam - 14-16 May 2014

Background: Rugby is a high intensity contact sport, frequently causing shoulder injuries. In the adolescent years, academy and county level players are being selected for professional contracts, so this is a critical stage of their career. There are currently a limited number of studies on this important group of athletes.

Objectives: The aim of this study was to describe the injury patterns, management and outcomes of serious shoulder injuries in adolescent rugby players. 
Methods: All academy and county level rugby players in the age group of 12 to 18 years of age were included in this study. All sustained injuries playing rugby and presented to the senior author over a 6-year period. Data collected included the mechanism of injury, clinical findings, radiology, surgical findings and recurrence rate at a minimum of 2 years post reconstruction.

Results: 142 cases fitted the inclusion criteria and were available for follow-up. Most cases had two or more pathologies in the shoulder (52%), mainly occurring during a tackle. The commonest pathology was a Bankart tear (44%), followed by reverse Bankart tears (27%), Bony Bankart (23%) and SLAP tears (16%). There was a 5% incidence of HAGL tears, 1% ALPSA lesions and 2% rotator cuff tears. Forwards sustained more shoulder injuries than backs. The mechanism of injury frequently correlated with player positions 
All repairs were arthroscopic, except for 12 open Latarjet procedures (11 were revisions). There was a 17% recurrence rate, with forwards (6%) and higher level academy players (10%) most likely to suffer a recurrence. 

Conclusions: This study highlights the significance of shoulder injuries in this important group of contact athletes. It is clear that the injury patterns are complex, but the majority can be managed with arthroscopic techniques. The recurrence rates are higher than older athletes and this may affect the management options. 




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