Tag rugby: a safe alternative? A review of hand injuries sustained playing tag rugby (2007 season)

The prevalence of hand and wrist osteoarthritis in elite former cricket and rugby union players

Objectives

This study aimed to determine the prevalence of hand and wrist osteoarthritis in former elite cricket and rugby union players, by sport and playing position, and to define the prevalence of severe hand injury, and its association with hand osteoarthritis.

Design

Cross-sectional.

Methods

Data from cross-sectional studies of former elite male cricket and rugby players were used to determine the prevalence of hand pain, physician-diagnosed osteoarthritis, and previous severe injury. Multivariable logistic regression was used to determine the association of previous injury with pain and osteoarthritis.

Results

Data from 200 cricketers and 229 rugby players were available. Complete case analysis resulted in 127 cricketers and 140 rugby players. Hand pain was more prevalent amongst cricketers (19.7%) than rugby players (10.0%). The prevalence did not differ between cricket and rugby players for hand osteoarthritis (2.4% and 3.6%), wrist osteoarthritis (1.6% and 2.1%), or previous severe hand injury (36.2% and 31.4%). No significant association between previous hand injury and pain or osteoarthritis was identified in either sport.

Conclusions

Former elite cricketers reported more hand pain than rugby players. No significant association was found between self-reported severe injury and hand osteoarthritis in either cohort, potentially indicating that risk factors aside from injury may be more prominent in the development of hand osteoarthritis.

Finger Injuries in Football and Rugby

Football and rugby athletes are at increased risk of finger injuries given the full-contact nature of these sports. Some players may return to play early with protective taping, splinting, and casting. Others require a longer rehabilitation period and prolonged time away from the field. The treating hand surgeon must weigh the benefits of early return to play for the current season and future playing career against the risks of reinjury and long-term morbidity, including post-traumatic arthritis and decreased range of motion and strength. Each player must be comprehensively assessed and managed with an individualized treatment plan.

A Five-Year Review of Tag Rugby Hand Injuries

Tag rugby is one of the fastest growing sports in Ireland. It is a soft-contact team game that is loosely based on the rugby league format except players try to remove Velcro tags from their opponents' shorts rather than engage in a typical rugby tackle. The purpose of this study was to examine all tag rugby associated hand injuries over a five-year period in three large tertiary referral hospitals in Ireland. Using the patient corresponding system, 228 patients with hand injury related tag rugby injuries were observed from 2010 to 2015. There were 138 males and 90 females in the study and over 40% of patients required surgery. Most of the patients were young professionals with an average age of 30. Twenty-five patients worked in the financial services whilst there were 23 teachers. Fractures accounted for 124 of the 228 injuries and mallet injuries accounted for 53. Eighty percent of all injuries occurred during the tackle. The mean number of days missed from work was 9.1±13.8 days. These injuries resulted in an average of seven hospital appointments per patient. Considering it is a soft-contact sport, it is surprising the number of hand injuries that we have observed. Although safety measures have been introduced to decrease the number of hand injuries in recent years, there is a need for further improvements. Better player education about seeking prompt medical attention once an injury occurs, coupled with longer shorts worn by players may improve measures for the sport.

Oztag: high risk for hand injuries?

BACKGROUND

Oztag is an Australian tag rugby code in which opponents are 'tackled' by removing Velcro tabs from their shorts. It is assumed to be safer than other higher-contact rugby codes.

METHODS

Oztag-related hand injuries were identified by a word search of the electronic emergency department records of Concord Repatriation General Hospital from January 2011 to October 2013. Clinical records were retrospectively reviewed.

RESULTS

Twenty-eight presentations were identified. Mean age of patients was 24 years (range 13-38). Injuries included fractures, dislocations and ligamentous injuries, in isolation or combination. The most common injuries were middle phalangeal fractures (six), all of which required operative fixation. No tendon avulsions were identified. The most common mechanism of injury was attempted tackle, which was much more likely to require operative management than any other mechanism (70% versus 14%, P = 0.010).

CONCLUSIONS

While the prevalence of Oztag-related hand injuries may be low, the occurrence of potentially debilitating injuries in a young, working population raises concern. The 'tag' tackle, which involves players running at speed with outstretched fingers, is particularly high risk. Prospective audit of injuries is required and players and organizers should be made aware of the dangers of this 'low-contact' sport.