Golf-Related Pediatric Injuries

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December 31, 2012
Edward Smith

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 have reported an increase in golf-related head injuries involving children, 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. They were able to perform a retrospective review of all golf-related injuries that occurred from January 2000 through April 2010. 13 kids 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 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 home and backyard. There was no specific parental guidance when these injuries occurred. The researchers concluded that, in fact, golf clubs can cause serious injury. A specific pattern of injury has not been previously described, called the “swing ding” by the authors, because it always happens during a golf club swing. It happens when a child stands 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 primary cause of these types of injuries, as well as the lack of experience the children had around golfing and the possibility of golf injuries being so serious. Children must learn to avoid golfers wildly 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.