title: The epidemiology, morbidity and outcome of fractures in rugby union from a standard population.
abstract: BACKGROUND
  Rugby union is the second commonest cause of sporting fracture in the UK, yet little is known about patient outcomes following such fractures.
  
  
  OBJECTIVE
  To describe the epidemiology of fractures in rugby union, their morbidity and the likelihood of return to rugby post-injury in a known UK population at all skill levels.
  
  
  METHODS
  All rugby union fractures sustained during 2007-2008 in the Edinburgh, Mid and East Lothian populations were prospectively recorded, when patients attended the only adult orthopaedic service in Lothian. The diagnosis was confirmed by an orthopaedic surgeon. Patients living outside the region were excluded from the study. Patients were contacted by telephone in February 2012 to ascertain their progress in return to rugby.
  
  
  RESULTS
  A total of 145 fractures were recorded over the study period in 143 patients. The annual incidence of rugby-related fractures was 0.28/1000 of the general population and 29.86/1000 of the adult registered rugby playing population. 120 fractures were of the upper limb and 25 were of the lower limb. 117 fractures (81%) in 115 patients (80%) were followed up at a mean interval of 50 months (range 44-56 months). 87% of the cohort returned to rugby post-injury (87% of upper limb fractures and 86% of lower limb fractures), with 85% returning to rugby at the same level or higher. Of those who returned, 39% did so by 1 month post-injury, 77% by 3 months post-injury and 91% by 6 months post-injury. For those who returned following upper limb fractures, 48% did so by 1 month post-injury, 86% by 3 months post-injury and 94% by 6 months post-injury. In patients who returned following lower limb fractures, 0% did so by 1 month post-injury, 42% by 3 months post-injury and 79% by 6 months post-injury. From the whole cohort, 32% had ongoing fracture related problems, yet only 9% had impaired rugby ability secondary to these problems.
  
  
  CONCLUSIONS
  Most patients sustaining a fracture playing rugby union will return to rugby at a similar level. While one third of them will have persisting symptoms 4 years post-injury, for the majority this will not impair their rugby ability.
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom. Electronic address: greg_robertson@live.co.uk.
authors.forename: Greg A J
authors.initials: GA
authors.lastname: Robertson
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Wood
authors.affiliation: University of Glasgow, United Kingdom.
authors.forename: Kieran
authors.initials: K
authors.lastname: Heil
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Aitken
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Court-Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D001265:Athletic Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D005538:Football; D050723:Fractures, Bone / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007869:Leg Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014954:Wrist Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery
keywords: Epidemiology; Fracture; Morbidity; Return; Rugby union