Spinal cord injuries in South African Rugby Union (1980 - 2007).
OBJECTIVE
To address an apparent increase in the number of rugby-related spinal cord injuries (SCIs) in South Africa, a retrospective case-series study was conducted on injuries that occurred between 1980 and 2007. We aimed to identify preventable causes to reduce the overall rate of SCIs in South African rugby.


METHODS
We identified 264 rugby-related SCIs. A structured questionnaire was used, and it was possible to obtain information on a total of 183 players, including 30 who had died.


RESULTS
SCIs increased in number in the 1980s and in 2006. Forwards sustained 76% of all SCIs, and club players 60%. Players aged 17 had the highest number of SCIs. In only 50% of cases were medical personnel present at the time of injury, and 49% of injured players waited longer than 6 hours for acute management. Of players with an SCI, 61% had a catastrophic outcome after 12 months, including 8% who died during that time; 65% received no financial compensation; and only 29% of players had medical aid or health insurance.


CONCLUSIONS
A register of all rugby-related SCIs in South Africa is essential to monitor the magnitude of the problem, identify potential risk factors, and formulate appropriate preventive interventions. The lack of reliable denominator data limits calculation of incident rates. Players from previously disadvantaged communities in particular suffered the consequences of limited public health care resources and no financial compensation.
Hermanus
Fiona J
FJ
School of Public Health and Family Medicine, University of Cape Town, South Africa.
Draper
Catherine E
CE
Noakes
Timothy D
TD
D000293:Adolescent; D002574:Cervical Vertebrae / Q000293:injuries*; D005538:Football / Q000293:injuries*; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D004204:Joint Dislocations / Q000453:epidemiology / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology*; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult