Golf Injuries: A Review Of The Literature (P5)
Major Injury – Head and Eye Injuries
Although very uncommon, injuries to the head and eyes occur in golfers. A relatively large body of literature is devoted to this type of golf-related injury. Most injuries are the result of being struck by either a stray golf ball, or getting struck by the club head of a fellow competitor during their swing.
This mechanism of injury is extremely uncommon, but has the potential to cause the greatest amount of injury. Due to the size of the ball and the speed that it can achieve, damage to the region it hitscan be quite large. The same can be said for being struck by a club. Standing behind someone who unexpectedly takes a practise swing or standing too close to them during a golf swing is the most common source of this injury mechanism. This is particularly true for the younger population.
A 1991 study at a regional referral centre for children with head injuries found that, over 1 year, 11 golf-related injuries were seen (232 total head injuries and 27 sports related). All of these children were boys with nine sustaining skull fractures (seven required surgery to elevate a depressed fracture). Nine injuries were the result of being struck by a club and two by a golf ball. Interestingly, only one was sustained on the golf course and none of the 11 had adult supervision. Overall, these 11 injuries sustained accounted for 40% of all the sports-related injuries seen, 50% of all depressed skull fractures seen, 18% of all skull fractures and 4.7% of all hospital admissions. Care must be taken to reduce the chance of these incidents occurring by having an adult supervise children playing golf. This adult needs to know how the swing works so as to keep the children a safe distance from the child swinging the club and also not in front of where the ball is being aimed. Sensible supervision can possibly eliminate the majority of these injury cases.
Around the golf course, players can be hit by a stray ball. The shouting of the word ‘fore’ is the common way of informing golfers that a golf ball is headed in their direction. To reduce the chance of being seriously injured when this occurs, the golfer should keep in the same spot, turn their back to the call and duck down whilst covering their face and head with their hands. Many times on the golf course you see golfers responding to the call of ‘fore’ by turning in the direction of the call and looking up into the air. This position exposes the face, eye and head to the flight of the ball, which can cause significant damage if it strikes these areas.
Eye injuries as a result of golf can sometimes occur. However, compared with sports such as racquet sports (squash in particular), football and hockey their occurrence is extremely low.
As stated previously in this section, the golf ball and golf club are often travelling high speeds and are small enough to fit within the orbital rim of the skull. A 1980 case study reported a patient present ing to hospital. History revealed the ball had travelled approximately 183m and struck the patient in the left eye by a golf ball. Immediate and complete visual loss occurred. X-ray revealed no fracture. After 2 months there still was no sight in the eye. A 6-year retrospective study on patient treatments at the University of Michigan hospital report ed nine golf-related ocular injuries. Seven of these injuries were the result of being struck by a golf ball, with the other two the result of being struck by a golf club. Eight of the nine patients had a ruptured globe. Enucleation of the eye was required in six patients. Being struck by a ball accounted for four of these procedures and two resulted from club head strikes. Interestingly, if the subject was wearing glasses at the time of being struck by the golf ball, only one out of the four patients required enucleation. A further case study demonstrated a optic nerve avulsion as a result of a 10 year-old child being hit by a golf club.
Head injuries as the result of falling out of a golf cart are rare occurrences but have been reported in the literature. Tung et al. reports on three cases of head injuries from golf buggy falls. One case sustained a moderate head injury with a small cerebral contusion and skull fracture. Two cases sustained severe head injuries involving extensive cerebral contusions and extradural haematoma, which required craniotomy. Two of the three made good recoveries, the other remained in a vegetative state. What cannot be answered from these studies was the cause of the fall and if age was a factor in a fall from the cart, or was negligence a factor (i.e. cart driversnot following appropriate instructions for use)? Be cause of increased litigation, all golf buggies have handling instructions informing occupants of the risks associated with their use.