Posters

Abstract

Head P10-916Head injuries in elite soccer players: "the need for harsher regulations" D'Hooghe P.P. 1 , Medical Committee of the Belgian National Soccer Federation 1 Stedelijk Ziekenhuis Roeselare, Orthopaedic Surgery, Roeselare, Belgium Head injury is reported to account for up to 22% of all injuries in soccer, although this includes all severities of injury and the injury mechanisms are not well described. Many well documented clinical investigations provide valuable information about the frequency, the circumstances and the biomechanical parameters associated with head impact in soccer. There remains however an inconclusive amount of evidence whether head impact during aerial challenge in soccer results in long-lasting visual, cognitive, proprioceptive and psychological problems. In 8 years experience as an orthopaedic sportstraumatologist, a number of elbow-to-head and head-to-head injuries in soccer drew my specific attention. Not only the devastating energy impact on the head and the slow recovery of the athlete but certainly also the loose rule enforcement of this type of heading duel injury, is difficult to oversee. FIFA´s guidelines are nevertheless simple: ´a red card is given in any case of an elbow kick whether there was an intention or not.´ The impression of me and many of my colleagues is that the impact of this kind of injury on the athlete goes way beyond the concussion recovery or the consolidation of an orbital or zygomatic cranial fracture. Literature suggests especially a high incidence of concussion and serious neck injury in this type of impact but no studies report the timing towards a full return to elite sport again. Our experience is that the cognitive, proprioceptive, visual and psychological deficits remain even months after the elbow-to-head incident. Initial fracture healing in cranial impact injury during soccer allows the player to regain his physical abilities quite quickly, but the subtle changes in fast tactical decisions, proprioception, heading towards a ball and visionary status last for much longer. This is why more stringent rules or punitive sanctions must be warranted for this type of impact on the head during game play. Our suggestion -that was discussed at the latest medical committee of FIFA -is to restrain the attacker from the pitch untill the full recovery of the attacked player is reached, even if the television replay would suggest an unintended type of elbow kick impact during aerial challenge. These suggestions are made, based on the fact that this is one of the major injuries that an elite soccer player can suffer from in his career and based on the possible long-lasting effects of this injury, experienced by the players. We present a review of the literature on this important topic, stuffed with specific videos during game play and videos of biomechanical subject testing. We ask the ESSKA floor to share our thoughts on this topic with our sports-traumatological colleagues and hope to convince the floor that further studies are needed especially on the long-te...