As the number of children taking to the links has steadily risen, so too has the number of pediatric golf-related head injuries.
Golf-related accidents were the second most common cause of sports injury, after bicycle use, among 2,546 patients younger than 19 years who were evaluated by neurosurgeons for any cause at the Medical College of Georgia in Augusta between 1996 and 2002.
A chart review revealed 64 sports injuries, 15 (23%) of which were golf related, according to Scott Y. Rahimi, M.D., lead author and neurosurgery resident at the medical college.
Seven of the golf injuries were caused by golf cart accidents, seven by golf clubs, and one by a golf ball (J. Neurosurg. [Pediatrics 2] 2005;102:163–6).
The mean age of the children in the study was 7 years, and the youngest was 9 months.
The most common injury was depressed skull fracture, which occurred in 7 (47%) of the 15 cases, followed by nondisplaced skull fracture in 3 (20%), subarachnoid hemorrhage in 2 (13%), epidural hematoma in 2 (13%), and subdural hematoma in 1 (6%), Dr. Rahimi reported.
Six children underwent neurosurgical procedures to treat their injuries. Twelve patients made a full recovery, including nine patients who were managed conservatively.
One child developed chronic headaches after a 3-year follow-up.
Another child required permanent shunt placement and underwent multiple shunt revisions because of device malfunction. One child died due to uncontrollable cerebral edema following a golf-cart accident.
A review of the literature by the investigators found that not only are golf-related injuries increasing, but they are the leading type of sports injury in regions where golf is popular, Dr. Rahimi and his colleagues wrote. For examplet, Augusta, Ga., where this research was conducted, is home of the Masters Golf Tournament and a hotbed of golf enthusiasm.
The authors cite a 1997 review of head injuries at the Westchester Medical Center in New York in the 3-month period following Tiger Woods' first Masters championship. The review showed that of the eight children who required surgery for their head injury, half had a depressed skull fracture from a golf club. No similar golf injuries were seen in the 12 months prior to Mr. Woods' win (Surg. Neurol. 1998;50:608).
A report by the Consumer Product Safety Commission identified 19 deaths between 1973 and 1996 that were a direct consequence of children playing with golf clubs (Percept. Mot. Skills 1998;86:747–53).
Golf-related injuries most often involve golf clubs and balls and occur at parks and homes, rather than at golf courses.
Still, the author noted, the growing use of golf carts also has contributed to the increase in accidents.
As a way to prevent or reduce injuries, Dr. Rahimi and his colleagues recommended precautionary guidelines and safety training programs, proper storage of golf clubs, adult supervision of golf-club and golf-cart use, and the requirement of a minimum legal age to drive a golf cart.
In Georgia and many other states, it is illegal to drive a golf cart without a valid driver's license.
At left, a CT scan shows a depressed skull fracture from a golf-related injury. On the right, a scan shows such a fracture repaired with titanium screws and plates. Photos courtesy Dr. Scott Y. Rahimi
