Golf-Related Pediatric Injuries

Children can be injured in playing or watching the game of golf. The worst injuries are golf-related head injuries in which a ball or the club can strike the child in the head, resulting in severe injuries to the skull and brain. The ball is essentially a large missile that can cause a comminuted skull fracture or a depressed skull fracture. This can cause bleeding within the brain or a hematoma outside of the brain but beneath the skull.

Recently, researchers report an increase in golf-related head injuries involving children and especially adolescents. The researchers have found a unique pattern of traumatic brain injury particularly associated with a swinging club. In the study, the researchers describe the mechanism of this injury and show how they managed to treat these types of injuries.

The authors performed a review of patients seen at two trauma centers and were able to perform a retrospective review of all golf-related injuries that occurred from January 2000 through April 2010. There were 13 kids who sustained a head injury from golfing accidents. Nine were boys and 4 were girls. The charts were reviewed and the parents were given follow up interviews to understand the details of the accident and the outcome.

In looking at the injury pattern, the researchers identified 13 depressed skull fractures as well as 7 epidural hematomas and one cerebral contusion. All thirteen patients had their head injury after being hit in the head by a golf club. Seven of the patients had their traumatic brain injury from being struck during the follow through of the swing; three sustained injuries during the back swing of the club. All patients required neurosurgical assistance except for one patient. Five patients subsequently developed neurological complications. No child had previous experience with golf and golf equipment.

All but one injury occurred in the child’s own home, in their backyard. There was no specific parental guidance when these injuries occurred. The researchers concluded that, in fact, golf clubs can cause serious injury. There is a specific pattern of injury that has not been previously described, called the “swing ding” by the authors because it always happens during a swing of the golf club. It happens when a child is standing too close to a swinging golf player and is struck on the head. The end result is a comminuted, depressed fracture of the skull, usually in the frontal area or the temporal region of the skull, which may or may not lead to a traumatic brain injury. The study pointed toward the lack of supervision as being the major cause of these types of injury as well as the lack of experience the children had around golfing and the possibility of golf injuries being so serious. Children need to learn to stay away from golfers, especially when swinging heavy clubs.

Doctors need to be aware of the probability of a golf swing fracture of the skull and to do the proper x-rays and probably a CT scan of the head to look for the probability of subdural or epidural hematomas or even contusions of the brain caused by the depressed nature of the skull fracture.