Kids have upswing in golf-related head injuries

Apr 5 2005

Children’s increasing interest in golf is resulting in an unfortunate upswing in golf-related head injuries, according to a review of sports injuries treated over six years at an academic medical center in Georgia.

A review of 2,546 patients under age 19 seen by pediatric neurosurgeons at the Medical College of Georgia in Augusta between 1996 and 2002 revealed 64 sports-related injuries, 15 of which were golf-related, says Dr. Scott Y. Rahimi, neurosurgery resident and lead author on the study published in the March issue of Journal of Neurosurgery. Seventeen bicycle-related head injuries during that period barely beat out golf as the major cause of sports-related head injuries in these children.

Seven of the golf injuries were caused by golf cart accidents, seven by golf clubs and one by a golf ball, Dr. Rahimi says. Uncontrollable brain swelling resulted in the death of one child in a golf-cart accident and six of the 15 children needed surgery. Five of the six children who needed surgery did well and the remaining nine had excellent outcomes, he says. The youngest patient with a golf-related head injury was 10 months old.

The popularity of the sport (Augusta is home to the Masters Golf Tournament) and MCG’s designation as an adult and pediatric trauma center likely account for the number of serious golf-related injuries treated at MCG, Dr. Rahimi says.

An occasional golfer himself, Dr. Rahimi got the idea for the study because he noticed an increase in these injuries. “At one time there were two children with golf-related injuries in the hospital,” he says, although he suspected a review would find contact sports, such as football or basketball, as more common causes of childhood sports injuries.

“Golf-related injuries constitute a common type of sports injury in the pediatric population. The increase in frequency of these injuries is largely attributed to the increase in the popularity of golf and greater use of golf carts by children,” Dr. Rahimi and his co-authors write, attributing the increasing popularity to the excitement generated by Tiger Woods and increasing media coverage of golfing events. A 1997 review of head injuries in children treated at the Westchester Medical Center in New York in the three-month period following Mr. Woods’ first Masters Championship showed of the eight children who required surgery, half had a depressed skull fracture from a golf club.

The MCG study also cited the depressed skull fracture – where a portion of the skull is broken on impact and underlying brain may be bruised – as the most common golf-related head injury, Dr. Rahimi says. In these cases, neurosurgeons piece the skull back together with titanium screws and plates and monitor the children for potentially dangerous brain swelling.

He noted that most of the injuries occurred in a neighborhood or park rather than a golf course. “But it doesn’t matter where you get hurt. It’s the same mechanism of injury.”

Much like a 1996 study in North Carolina that showed a 32 percent increase in golf-cart related injuries in children age 10 and younger, the increasing use of golf carts by children in the Augusta area has resulted in an increase in injuries, Dr. Rahimi says. Children can be easy targets for head and spine injuries in these types of moving accidents because their heads are larger proportionally to their growing bodies, he says.

The MCG authors suggest precautionary guidelines and safety training programs to reduce golf-related injuries, proper storage of golf equipment and adult supervision of golf club and golf cart use. Most states, including Georgia, require a driver’s license to operate a golf cart on roadways.

Dr. Rahimi already has taken his findings to heart by taking more time to ensure no one is within range of his club or, hopefully, his ball wherever he plays, a precaution recommended in the first paragraph of the “Rule of Golf Handbook,” published by the U.S. Golf Association and The Royal and Ancient Golf Club of St. Andrews.

Co-authors include Dr. Harshpal Singh, a 2004 MCG graduate; Dr. David J. Yeh, who completed his medical degree and neurosurgery residency at MCG; Dr. Ellen G. Shaver, neurosurgeon at MCG and the Veterans Affairs Medical Center in Augusta; Dr. Ann Marie Flannery, former MCG pediatric neurosurgeon now of the faculty of Saint Louis University; and Dr. Mark R. Lee, chair of the MCG Department of Neurosurgery.