Fore! A 10-year Analysis of Golf-related Facial Fractures

A Scoping Review of the Epidemiology, Management, and Outcomes of Golf-Related Fractures

ABSTRACT

Golf is a popular sport; however, there is a paucity of data in relation to golf-associated fractures, and the rate and timing of returning to golf. The aim of this review is to describe golf-associated fractures, including epidemiology, management, and timing of returning to golf following treatment. A literature search was performed using MEDLINE/PubMed, Embase, and Web of Science. Data were extracted and summarized in a narrative synthesis. A total of 436 articles were identified with an initial search of which 58 met the inclusion criteria. Twelve anatomical sites of golf swing-related fractures were identified, of which 10 sites were specific for stress fractures. The most common sites of golf swing-related stress fractures were the ribs followed by the hook of hamate. There was a common theme of delay to diagnosis, being initially assigned to a soft tissue injury. Most golfers with swing-related stress fractures were able to return to golf with the exception of osteoporotic associated vertebral stress fractures. Timing of returning to golf was between 4 and 12 months for most of the golfers with stress fractures following conservative management. Operative intervention was an option of hook of hamate nonunion, following a stress fracture, and tibial shaft stress fractures. Golf equipment-related fractures were not rare and were associated with major trauma and in some cases associated with significant persistent morbidity. Golf-related stress fractures commonly involve the ribs and hook of hamate; knowledge of this may aid in early diagnosis and appropriate treatment when symptomatic golfers are encountered. Although golf is a noncontact sport, fractures associated with golf equipment can be life changing, and safety training guidelines should be established.

Analysis of Pediatric Facial Fracture Repair Rates and Complications Using California's Office of Statewide Health Planning and Development Database

BACKGROUND

There exists a paucity of data on which pediatric facial fractures should be surgically repaired and when. In this study, the authors used a California state-wide database to determine the prevalence of facial fractures in the pediatric population and examine, which fractures are repaired. in addition to the timing of the repair, complications and resource utilization of the healthcare system were analyzed.

METHODS

Pediatric patients under the age of 18 were identified using the California Office of Statewide Health Planning and Development patient discharge database for admissions occurring between January 2015 and December 2018. International Classification of Diseases, Version 10 diagnosis codes were used to classify facial fractures. The associated diagnoses, complications, and number of subsequent repairs patients underwent were analyzed to determine the typical course of pediatric facial fractures.

RESULTS

Of the 3058 patients diagnosed with facial fracture, 32% underwent surgical repair (N = 982). The 4 most repaired fractures were mandible (40%), nasal (16.2%), and orbital (15.1%). Surgical intervention steadily increased with age, with a peak in the 12 to 15-year-old cohort.

CONCLUSIONS

Our analysis found that most fractures were managed nonoperatively, but those that did receive an operation did so during their index admission. In addition, the most repaired fractures were mandibular, nasal, and orbital fractures. The present study represents 1 of the largest pediatric samples to have assessed facial fractures, repair rates, and their sequelae.