Teenage rugby players should be chosen on the basis of their size and not their age to prevent horrific injuries, doctors have warned.
The caution comes after they described a slew of cases where young athletes suffered bone fractures typically associated with car crash victims.
As a result, they have called for a ban on full-contact rugby in schools to prevent the 'potentially devastating consequences of these injuries'.
The warning follows a plea last week by more than 70 doctors and health experts wrote to the Government calling for the sport to be replaces by touch rugby in schools.
Full-contact rugby in schools should be banned to prevent the 'potentially devastating consequences of these injuries' according to doctors writing in BMJ Case Reports
Doctors from the department of trauma and orthopaedics at Tallaght Hospital, Dublin, described three cases where young players were seriously injured during rugby tackles.
They said the types of fractures the patients suffered were 'acetabular fractures... (which) affect the socket of the hip bone, and are generally sustained after violent trauma, such as road traffic accidents'.
The teenagers were aged 13 to 16 when they were injured - according to the article in BMJ Case Reports.
Two occurred while playing a rugby union match and the other during a training drill.
The injuries followed pressure exerted through a flexed hip with the knee on the ground - a position that can be encountered during a two-man tackle, as one tackler hits low and the other hits high, the doctors wrote.
The boys suffered three fractures in total together with hip dislocations and all recovered following surgery and rehabilitation.
Doctors said acetabular fractures which affect the socket of the hip bone and need surgery (pictured), are generally sustained after violent trauma
'In order to prevent the potentially devastating consequences of these injuries it may be necessary to implement rule changes or size restrictions in the juvenile game,' the doctors said.
'Many schools and juvenile rugby clubs have adopted a more professional attitude towards the game, with a significant emphasis being placed on weight training and physical size.'
The doctors noted that in addition to the problems of excessive force on an immature skeleton, players' bodies developed at different rates in terms of size and bone age.
This difference can be magnified during tackles and rucks, when physically bigger players come up against weaker counterparts, they said.
In last week's open letter from academics and health professionals, which was addressed to ministers, chief medical officers and children's commissioners, rugby is described as a 'high-impact collision sport'.
The signatories said studies show the risks of injuries to under-18s 'are high and injuries are often serious'.
The Rugby Football Union said 'high quality coaching, officiating, medical support and appropriate player behaviour' would help to reduce the risk of injury.
It noted the sport in English schools or clubs can be played as either contact or non-contact.
The Department for Education said it expects schools to 'be aware of the risks associated with sporting activities and to provide a safe environment for pupils'.
The Rugby Football Union said 'high quality coaching, officiating, medical support and appropriate player behaviour' would help to reduce the risk of injury
Stating that team sports can be character-building and help to develop positive traits such as fair play, leadership and resilience, a spokesman said: 'PE and sport can help ensure that all young people realise their potential and is an important part of our commitment to preparing children for life in modern Britain.'
Professor Allyson Pollock, an expert in Public Health at Queen Mary, University of London, has spent years campaigning for contact rugby to replaced by touch rugby to prevent accidents.
A study she led last year found as many as one in eight children who play the sport at school will suffer injuries serious enough that they will need to miss at least seven training sessions or matches.
A study by the University of London found one in eight children who play rugby at school will suffer injuries serious enough that they will need to miss at least seven training sessions or matches (file photo)
These range from bruises and sprains to fractures, torn ligaments and at worst, concussion and damage to the brain and spinal cord.
She criticised the Government's plans to to increase competitive sports in school, and called on said it needs to do more to monitor the number of injuries.
Writing in the BMJ, she said the Government had a ‘duty to protect children from the risks of injury’ as part of a law enshrined by the United Nations.
She also pointed out that other countries such as New Zealand monitor the number of rugby injuries compares to the population, making it possible to work out how risky it is compared to other sports.
Currently, rugby is mainly played at independent schools rather than state schools where the dominant sport for boys is football.
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