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Scand J Med Sci Sports. 2017 Dec;27(12):1986-1992. doi: 10.1111/sms.12839. Epub 2017 Feb 3.

Head injuries in children's football-results from two prospective cohort studies in four European countries.

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Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
Medical School Hamburg, Hamburg, Germany.
Swiss Concussion Center (SCC) and Schulthess Clinic, Zurich, Switzerland.
Institute of Sports and Preventive Medicine, Saarland University, FIFA-Medical Centre of Excellence, Saarbrücken, Germany.
Department of Orthopaedics, 1st Faculty of Medicine of Charles University and Hospital Na Bulovce, FIFA-Medical Centre of Excellence, Prague, Czech Republic.
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Department of Neurology, Interdisciplinary Center for Vertigo and Neurological Visual Disorders, University Hospital & University of Zurich, Zurich, Switzerland.


Head injuries are considered harmful in children. We analyzed head and neck injuries in organized football in 7- to 12-year-old children. Data for this analysis were obtained from a prospective cohort study over two consecutive football seasons in two European countries, and a randomized intervention trial over one season in four European countries. Football exposure and injuries were documented through an online database. Detailed information regarding injury characteristics and medical follow-up was retrieved from coaches, children and parents by phone. Thirty-nine head injuries and one neck injury (5% of all 791 injuries) were documented during 9933 player-seasons (total football exposure 688 045 hours). The incidence was 0.25 [95%CI 0.15, 0.35] head/neck injuries per 1000 match hours (N=23 match injuries) and 0.03 [95%CI 0.02, 0.03] per 1000 training hours. Eleven concussions (27.5%), nine head contusions (22.5%), eight lacerations or abrasions (20%), two nose fractures (2.5%), and two dental injuries (2.5%) occurred. The remaining eight injuries were nose bleeding or other minor injuries. Thirty injuries (75%) resulted from contact with another player, and ten injuries were due to collision with an object, falling or a hit by the ball. Whereas 70% of all head injuries (N=28) were due to frontal impacts, 73% of concussions (N=8) resulted from an impact to the occiput. The incidence and severity of head injuries in children's football are low. Coaches and parents, however, should be sensitized regarding the potential of concussions, particularly after an impact to the occiput.


concussion; heading; soccer; traumatic brain injury; youth

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