“挥杆叮伤”：儿童中与高尔夫相关的头部损伤

Wang Arthur, Cohen Alan R, Robinson Shenandoah

Division of Pediatric Neurosurgery, University Hospitals Rainbow Babies and Children's Hospital, The Neurological Institute, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.

J Neurosurg Pediatr. 2011 Jan;7(1):111-5. doi: 10.3171/2010.10.PEDS10283.

OBJECT

In recent years there has been an increased incidence of golf-associated head injuries in children and adolescents. At the authors' institution, they have identified a unique pattern of head injury associated with a swinging golf club. In this study, the authors highlight the mechanism of this injury and report their experience treating it.

METHODS

The authors reviewed the database of Rainbow Babies and Children's Hospital Trauma Center and performed a retrospective analysis of golf injuries recorded over a 10-year period (January 2000-April 2010). They identified 13 children (9 boys and 4 girls) who sustained head injuries in golfing accidents. All patients were 10 years of age or younger. The medical charts were reviewed and follow-up interviews were conducted to better delineate the details of the injuries.

RESULTS

Injuries included 13 depressed skull fractures, 7 epidural hematomas, and 1 cerebral contusion. All 13 patients sustained their injuries after being struck in the head by a golf club. Seven sustained injuries on the follow-through of the initial swing and 3 sustained injuries on the backswing. All but one patient required neurosurgical intervention. Five patients developed neurological sequelae. None of the children had prior experience with golf equipment. All but one injury occurred in the child's own backyard. There was no direct supervision by an adult in any of the cases.

CONCLUSIONS

Golfing can lead to serious head injuries in children. The authors noticed a unique pattern of golf-related head injuries, previously not described, that they have termed the "swing-ding." This golf club-inflicted injury occurs when a child stands too close to a swinging golfer and is struck in the head, subsequently sustaining a comminuted depressed skull fracture in the frontal or temporal region, with or without further intracranial injury. The study suggests that a lack of adult supervision, minimal previous golf experience, and proximity of the child to the swinging golfer are all implicated in this head injury pattern.

目的

近年来，儿童和青少年中与高尔夫相关的头部损伤发生率有所上升。在作者所在的机构，他们发现了一种与挥动高尔夫球杆相关的独特头部损伤模式。在本研究中，作者强调了这种损伤的机制并报告了治疗经验。

方法

作者回顾了彩虹婴儿与儿童医院创伤中心的数据库，并对10年期间（2000年1月至2010年4月）记录的高尔夫损伤进行了回顾性分析。他们确定了13名在高尔夫球事故中头部受伤的儿童（9名男孩和4名女孩）。所有患者年龄均在10岁或以下。查阅了病历并进行了随访访谈，以更好地描述损伤细节。

结果

损伤包括13例颅骨凹陷性骨折、7例硬膜外血肿和1例脑挫伤。所有13例患者均在被高尔夫球杆击中头部后受伤。7例在初始挥杆的随挥过程中受伤，3例在回摆过程中受伤。除1例患者外，所有患者均需要神经外科干预。5例患者出现神经后遗症。所有儿童此前均无使用高尔夫设备的经验。除1例损伤外，所有损伤均发生在儿童自家后院。所有病例均无成人直接监督。

结论

高尔夫运动可导致儿童严重头部损伤。作者注意到一种此前未描述过的与高尔夫相关的独特头部损伤模式，他们将其称为“挥杆致伤”。当儿童站得离挥杆的高尔夫球手太近并被击中头部时，就会发生这种由高尔夫球杆造成的损伤，随后在额部或颞部区域发生粉碎性颅骨凹陷性骨折，伴或不伴有进一步的颅内损伤。该研究表明，缺乏成人监督、此前极少有高尔夫运动经验以及儿童与挥杆的高尔夫球手距离过近均与这种头部损伤模式有关。