Prevalence of laceration injuries in professional and amateur rugby union: a systematic review and meta-analysis

BACKGROUND: Studded footwear can cause severe lacerations in rugby union; the prevalence of these injuries is currently unknown. OBJECTIVE: To summarise the skin and laceration injury prevalence in published epidemiological studies and to investigate any differences in skin injury risk between amateur and professional players. DESIGN: Systematic literature review and meta-analysis of epidemiological studies. DATA SOURCES: PubMed, Web of Science, Scopus and Ovid. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective, epidemiological studies published in English after 1995, measuring a minimum of 400 match or 900 training exposure hours. Participants should be adult rugby union players (amateur or professional). The study should report a separate skin or laceration injury category and provide sufficient detail to calculate injury prevalence within this category. RESULTS: Twelve studies were included. Mean skin injury prevalence during matches was 2.4 injuries per 1000 exposure hours; during training sessions, the prevalence was 0.06 injuries per 1000 exposure hours. Skin injuries accounted for 5.3% of match injuries and 1.7% of training injuries. Skin injury risk was similar for amateur compared with professional players during matches (OR: 0.63, p=0.46.), but higher during training sessions (OR: 9.24, p=0.02). CONCLUSIONS: The skin injury prevalence of 2.4 injuries per 1000 exposure hours is equivalent to one time-loss injury sustained during matches per team, per season. Amateur players are more likely to sustain skin injuries during training sessions than professional players. There is a need for more studies observing injuries among amateur players. TRIAL REGISTRATION NUMBER: PROSPERO CRD42015024027.