Good et al. Journal of Medical Case Reports 2011, 5:505 http://www.jmedicalcasereports.com/content/5/1/505 C A S E R E P O R T JOURNAL OF MEDICAL CASE REPORTS Open Access Acetabular fractures following rugby tackles: a case series Daniel W Good*, Michael Leonard, Darren Lui, Seamus Morris and John P McElwain Abstract Introduction: Rugby is the third most popular team contact sport in the world and is increasing in popularity. In 1995, rugby in Europe turned professional, and with this has come an increased rate of injury. Case presentation: In a six-month period from July to December, two open reduction and internal fixations of acetabular fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described as well as the biomechanical factors contributing to the fracture and the recovery. Acetabular fractures of the hip during sport are rare occurrences. Conclusion: Our recent experience of two cases over a six-month period creates concern that these high-energy injuries may become more frequent as rugby continues to adopt advanced training regimens. Protective equipment is unlikely to reduce the forces imparted across the hip joint; however, limiting ‘the tackle’ to only two players may well reduce the likelihood of this life-altering injury. Introduction Rugby is the third most popular team contact sport in the world and is increasing in popularity [1]. Rugby Union underwent a major change in 1995 when the sport turned professional. With this also came an increased rate of injury [1]. Numerous studies have identified an increase in the rates of injury during both professional and amateur rugby in recent years [1-4]. Garraway et al. [2] suggested that this increase in injury incidence was due to an increased emphasis on speed, strength and stamina. Acetabular fractures are an uncommon injury with an incidence of approximately three per 100,000 population [5]. These fractures occur as a result of high-velocity trauma such as road traffic accidents, particularly in younger patients, and are associated with significant morbidity and mortality [6], including sciatic nerve injury and early post-traumatic arthritis. Acetabular fractures from sport are extremely rare, and we describe two cases which occurred during rugby union. In a six-month period from July to December, two open reduction and internal fixations of acetabular * Correspondence: goodd@tcd.ie Department of Trauma Orthopaedics and Reconstructive Pelvic and Acetabular Surgery, Adelaide and Meath Incorporating the National Childrens Hospital, Tallaght, Dublin 24, Ireland fractures were performed in young Caucasian men (16 and 24 years old) who sustained their injuries after rugby tackles. Both of these cases are described below. Case presentations Case 1 The first case was a 16-year-old, male Caucasian, weigh- ing 60 kg (body mass index (BMI) = 20.5), who incurred his injury playing school rugby. Running with the ball, he was tackled first from his left causing him to stumble to his right. He was then tackled by another player from his left, falling onto his flexed right knee. He felt immediate pain and he was unable to move his right leg. He was taken to his local hospital where images of his pelvis revealed a posterior fracture-dislocation of his right hip joint (Figure 1). This was reduced interopera- tively within two hours. Postoperatively he was trans- ferred to our institution for definitive management. A computerized tomography (CT) scan of his pelvis demonstrated a displaced fragment of the posterior wall of his acetabulum and an examination under anesthesia revealed instability of the joint. We elected to undertake open reduction and internal fixation. A posterior Kocher-Langenbach approach was performed and the posterior wall fragment was reduced and fixed with a two-hole spring plate (Figure 2). He underwent an © 2011 Good et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.