Sporting injuries have always contributed a significant proportion of the workload of the emergency department.¹ The number is increasing considerably² 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.

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Figure 1

 Football boot with blades.

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 laceration 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.

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Figure 2

 Laceration to left leg.

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 al³ 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 with injury incidence.⁶ These theories led directly to the development of the blade to replace the traditional stud on football boots to improve shoe-surface traction. For this reason a large number of professional footballers use blades, and as a result the appeal to amateur players of all ages is high. As the number of players using such footwear increases, the number of injuries resulting directly from blades is increasing also. Concerns are now being raised in the media as to the safety of such blades, especially in more junior grades of football.⁷ In certain countries there are moves to ban such blades because of safety concerns.⁷

These cases highlight the severity of lacerations that can result from tackles with boots fitted with blades. In the second case report, the blade was actually sharp enough to penetrate the leather uppers of the boot before lacerating the skin. Although stud injuries have presented to the emergency department for many years, we should be increasingly aware of the potential dangers of this design of stud, especially in junior levels of competition.