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Between 2000 and 2003 at a children’s hospital in Sydney, Australia with a designated paediatric spinal unit 1745 children under the age of 15 years presented with suspected cervical spinal injury and 125 had been playing rugby football at the time of injury (

) . Twenty-seven of the rugby players were under 11 years old. Ten had transient motor or sensory deficit and four transient quadriparesis. Rugby union players were more likely to sustain flexion/extension injury often in a scrum. Hyperextension injury sustained during a “spear” tackle occurred only in rugby league players. Twenty-nine players also had concussion, 24 had lacerations to the face or scalp, six had nose bleeds, six fractures of facial or limb bones, and two hyphaema. Thirty-nine were admitted to hospital but none needed surgery and none had permanent neurological disability. Two children had spinous process fractures, both following hyperextension in a spear tackle in rugby league. Immobilisation of the cervical spine at the scene of injury was performed in 96 cases. Cervical spine injury in children playing rugby football rarely leads to serious sequelae but continued education of players and referees is needed.

A 2 year old child with severe cerebral palsy was referred to the emergency department of a London teaching hospital with a mouth lesion (

) that presented problems in diagnosis and treatment. Her mother had noticed blood on the child’s …

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