2025 ISAKOS Biennial Congress ePoster
Low Rates of Return to Sport and Reduction in Performance Following Ankle Fractures in Elite Rugby Union Players
James J. Butler, MB, BCh, New York, New York UNITED STATES
Megan Calton, MD, Dublin IRELAND
Allison Greene, MD, Albany, NY UNITED STATES
Andrew Rosenbaum, Albany, NY UNITED STATES
Michael Mulligan, MD, Albany, NY UNITED STATES
Sebastian Krebsbach, BS, New York UNITED STATES
John G. Kennedy, MD, MCh, MMSc, FFSEM, FRCS (Orth), New York UNITED STATES
NYU Langone Health, New York, NY, UNITED STATES
FDA Status Not Applicable
Summary
Elite rugby union players who sustain ankle fractures have a 78.3% return-to-play rate within an average of 8.9 months, and experience significant declines in games played, tries scored, and points scored, highlighting the potentially devastating sequelae following ankle fractures in the elite athletic population.
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Abstract
Introduction
The purpose of this study was to assess outcomes following ankle fractures sustained by elite rugby union players.
Methods
Elite rugby union players who sustained an ankle fracture were identified using a publicly available database, match reports and injury reports. "Elite rugby union" was defined as a player who played professional rugby in the following competitions: United Rugby Championship, Top 14, English Premiership, Super Rugby and international rugby for a top 20 ranked team. The years of inclusion was from 2015-2022. Data collected and analysed: player demographics, player position, if surgical intervention was warranted, rates of return to play (RTP), time to return to play, games missed. Pre-injury and post-injury performance outcomes collected and analysed: games played, tries scored, points scored.
Results
107 elite rugby union players sustained an ankle fractures between 2014-2022 (0.0186 per 10,000 athlete-exposures). The mean age was 24.2±9.1 years and the mean BMI was 31.8±8.9kg/m2. There were 71 (61.3%) ankle fractures sustained by forwards and 36 (33.6%) ankle fractures sustained by backs. Ninety (84.1%) ankle fractures occurred during the in-season and 17 (15.9%) ankle fractures occurred during training. All athletes (100%) underwent surgical intervention. The most common mechanism of injury was direct trauma to the ankle during a tackle (55.9%). The RTP rate was 78.3% at mean time of 8.9±3.9 months. There was a statistically significant decrease in the mean number of games played, tries scored and points scored following RTP.
Discussion And Conclusion
This current study found that ankle fractures were an uncommon injury in elite rugby union players with an incidence of 0.0186 per 10,000 athlete-exposures. Sustaining an ankle fracture was associated with a RTP rate of 78.3% at mean time of 8.9±3.9 months. There was a statistically significant deterioration in key performance metrics such as mean games played, tries scored and points scored. This study reinforces the potentially devastating sequelae following ankle fractures in the elite athletic population.