Recidivism in sports related injuries in primary care.

LETTERS Football blades: a cause for concern Sporting injuries have always contributed a significant proportion of the workload of the emergency department. 1 The number is increasing considerably 2 for several reasons. A burgeoning range of sporting activities combined with increased disposable income and leisure time has led to greater participation. 2 Consequently research and development aimed at enhancing performance has escalated. One such development is the use of ''blades'' instead of the more traditional studs on football boots. Unlike the traditional round peg-like studs, the new blades measure up to 3 cm long and are shaped to contour the foot (fig 1), providing enhanced stability to the standing foot when kicking. Since they were first endorsed by high profile figures such as David Beckham, the appeal to the younger generations has increased to the extent that many junior players use such footwear. The traditional studs can cause a range of injuries, from minor lacerations (the most common) to more complex punched out soft tissue injuries. The cases described below highlight the potential severity of injuries sustained as a result of direct contact with a football blade. The first case involved a 14 year old boy with a laceration to the medial aspect of the left knee sustained after a tackle. The lacera-tion was 8 cm in length and extended down to muscle but had not involved the knee capsule (fig 2). The wound was thoroughly irrigated, debrided, and closed with sutures. The second involved a 28 year old man who was involved in a tackle with a player wearing football blades; as a result of the tackle the leather uppers of the football boot were torn with a ragged laceration measuring 5 cm over the dorsum of the foot. The laceration was irrigated, debrided, and sutured. Sporting injuries presenting to the emergency department are common, and, over the last decade more interest has focused on prevention. One aspect of this is footwear design. Chan et al 3 showed a direct correlation between footwear and both performance and rates of injury. A similar study showed that boots with a greater number of studs were associated with poorer performance compared with those with fewer, primarily because of inferior traction with the ground. 4 A large proportion of football injuries are ligamentous and involve either the knee or the ankle, 5 thus shoe-surface traction is the specific variable most likely to correlate …