Summary

The increased prevalence of the Olympic format rugby-7s highlights the importance of first responders and healthcare providers to be aware about the sport-specific trauma.

Abstract

A 22-year-old men’s club Division I Rugby-7s winger injured his right ankle, in a qualifying geographic union tournament match, after a simultaneous tackle by two opposing players. Tackler-one locked the ball carriers’ foot in place by wrapping the lower leg, and tackler-two changed the direction of the upper body of the player, inducing an ankle inversion directional force. Post-tackle, the injured player complained of pain and inability to bear weight on his right leg. His history noted no ankle supports/brace or tape used, and no previous history of ankle injury/surgeries. The sideline emergency services removed the injured foot cleat and found the ankle deformity, which was provisionally secured for transport. The emergency department examination documented a medially deformed right foot held in a plantar flexed and supinated position. No lacerations or open wounds were noted, and there were no concerns for neurovascular compromise. Initial ankle radiographs demonstrated a right posteromedial pan-talar dislocation without associated malleolar fractures. Immediate emergency department conscious sedation was obtained and a closed-reduction was performed. Post-reduction imaging was obtained to ensure proper reduction, and a short-leg cast was applied. The patient was made partial weight-bearing for 4 weeks, with rehabilitation focusing on range-of-motion and strengthening exercises thereafter. At 7 weeks post-injury, the patient was full weight-bearing. At his 3-month follow-up, the patient was cleared to return to sport and was noted to have no further episodes of instability with his exam demonstrating 7° of dorsi-flexion, 32° of plantar-flexion, 14° of inversion, and 10° of eversion.