Syndesmosis injuries in professional rugby players: associated injuries and complications can lead to an unpredictable time to return to play.

OBJECTIVES: Syndesmosis injuries are common and increasing in contact sports with a marked impact on players and teams alike. They can result in an unpredictable and often prolonged return to pre-injury level. We aim to evaluate the time to return to play (RTP) after syndesmosis injuries in professional male rugby players. METHODS: A cohort study including all professional rugby players with syndesmosis injuries, treated both operatively and non-operatively by the senior author was performed. The follow up period was a minimum of 12 months or until RTP. Players with previous ankle injuries or associated ankle fractures were excluded. Outcome measures included players age, body mass index (BMI), field position, seven-a-side or 15-a-side match, mechanism of injury, clinical findings, radiological findings, return to training (RTT), and RTP dates. RESULTS: For the period July 2015 to July 2019, a total of 13 professional male rugby players were included in the study. The leading mechanism of syndesmosis injury was in contact during a tackle. Six players had a grade 3 injury (40%), 4 players had a grade 2B injury (27%), 2 players had a grade 2A injury (13%) and 3 players had a grade 1 injury (20%). Two of the aforementioned players presented with new contralateral syndesmosis injuries during the study period. The median time for RTT and RTP was 97 days (IQR: 36) and 112 days (IQR: 54), respectively. All players with syndesmosis injuries were able to return to play. No discrepancy was found between seven-a-side and 15-a-side players regarding injury mechanism, injury severity, and RTP. CONCLUSION: Most syndesmosis injuries in professional rugby players are acquired during a tackle. These injuries are often unstable, requiring surgical intervention, with an unpredictable recovery period. Injury severity, surgical complications, delayed diagnosis, and associated injuries can prolong this period. The subtype of rugby (seven-a-side and 15-a-side) does not affect the injury severity or return to play. LEVEL OF EVIDENCE: Level 4.

Knee scooter related injuries and satisfaction in patients following foot and ankle surgery.

BACKGROUND: Knee scooters have become popular amongst foot and ankle surgeons for patients who are required to be non-weight bearing. Information is limited regarding falls and injuries sustained while using a knee scooter and potential contraindications to their use are ill-defined. No study has assessed patient reported injuries and satisfaction. This study aims to evaluates the patient's perspective with regards to the use of a knee scooter. As a secondary aim we assessed for risk factors associated with knee scooter related injuries to try make recommendations for the safe use of a knee scooter. METHODS: Patients who used a knee scooter during 2018-2020 were emailed a questionnaire assessing (1) demographic data, (2) medical history, (3) falls and injuries sustained, including the management of these injuries, and (4) patient satisfaction. This study is a descriptive, cross-sectional survey analysis. RESULTS: 101/196 (51,5%) responses were received, which included 32 males and 69 females. The cohort had a mean age of 56.4 years, and BMI of 28.5. Mean time spent using the scooter was 6.7 weeks. Twenty-five respondents had fallen off the scooter, with 5 reporting injuries. One patient required medical attention for a shoulder injury. Cause of falls included hitting an obstacle, making a sharp turn, moving too fast, and moving downhill. There was no correlation between falls and patient comorbidities. Ninety-six percent of respondents reported a high satisfaction and preferred the scooter to crutches. CONCLUSION: The knee scooter is a safe, and well-tolerated, mobility aid for patients requiring non-weight bearing during their recovery, with a high satisfaction rate. Educating patients on correct use and common causes for falling is important as a preventative measure. LEVEL OF EVIDENCE: IV, retrospective case series.