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Equestrian Sports

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Equestrian Sports

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Abstract

Statistically, riding is a dangerous sport despite many prevention campaigns and improved safety gear. This is – and always will be – because equitation is about the interaction between a human and an unpredictable large animal. Most injuries sustained in equitation are of minor severity and most of them probably do not lead to a doctor’s visit. However, those that are admitted to hospital are severe and have a poor outcome. Concerning specific foot injuries in equitation, literature is limited to just a few case reports. The most common foot injures are soft tissue injuries, such as bruises and contusions from horses standing on the feets or kicks with hoofs. Injuries to ligaments and bones can result from falls from the horse or due to trapping the foot under the horses’ body in falls with the horse.

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A retrospective study of horse riding injuries in Berkshire was undertaken over a one year period from November 1983. The information was obtained from the Ambulance Service, the Jockey Club and the St. John Ambulance Brigade. There was a total of 103 injured persons with no deaths. Information from the Jockey Club was compared with the other two groups, the former sustaining more limb injuries and the latter more head injuries. A questionnaire was sent to all 42 ambulance patients. Thirty-eight had radiographs taken, 16 of which showed a fracture. Forty-one were wearing some form of hard hat, but if a safety strap was available it was attached in 24 cases. The dangers of riding are highlighted and the importance of adequate protective clothing emphasised.
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To assess prospectively the incidence, nature, and severity of injuries to polo riders competing in the 1996 Argentine High Polo season. Assessment, documentation, and provision of care for all injuries sustained during the 1996 season by one of the authors. Riders were also surveyed retrospectively for their previous polo injuries. 34 riders took part in the study. Nine injuries were sustained prospectively and 55 injuries were reviewed retrospectively (64 total). The injuries were categorised as minor (10), moderate (13), and major (41). Twenty five (39%) injuries occurred in the arms, 20 (31%) in the legs, 12 (19%) in the head, 3 (5%) in the back, and 4 (6%) in the face. A fracture occurred in 25 (39%) injuries as most resulted from a fall from the horse. Additionally, facial lacerations occurred prospectively in five riders but did not result in missed play. An overall injury rate of 7.8/1000 player-game hours was calculated. Although many sports have injury rates much greater than 8/1000 player-game hours, the severity of most injuries occurring in polo was classified as major, with fractures and facial lacerations common. The use of a helmet with a face protector is recommended to decrease injury to players. A doctor experienced in the management of serious trauma should be present at all polo matches.
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In the sport of horse racing, the position of the jockey and speed of the horse predispose the jockey to risk of injury. To estimate rates of medically treated injuries among professional jockeys and identify patterns of injury events. Cross-sectional survey from data compiled by an insurance broker. Information on the cause of injury, location on the track, and body part injured was evaluated. Official races at US professional racing facilities (n = 114) from January 1, 1993, through December 31, 1996. A licensed jockey population of approximately 2700 persons. Annual injury incidence rates per 1000 jockey-years, as well as injury type, cause, and location on the track. A total of 6545 injury events occurred during official races between 1993 and 1996 (606 per 1000 jockey-years). Nearly 1 in 5 injuries (18.8%) was to the jockey's head or neck. Other frequent sites included the leg (15.5%), foot/ankle (10.7%), back (10.7%), arm/hand (11.0%), and shoulder (9.6%). The most frequent location where injuries occurred was entering, within, or leaving the starting gate (35.1%), including 29.5% of head injuries, 39.8% of arm/hand injuries, and 52.0% of injuries to the leg/foot. Most head injuries resulted from being thrown from the horse (41.8%) or struck by the horse's head (23.2%). Being thrown from the horse was the cause of 55.1% of back and 49.6% of chest injuries. Our data suggest that jockeys have a high injury rate. Efforts are needed to reduce the number of potential injury events on the track and to improve protective equipment so events do not lead to injury.
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To describe the demographics and nature of injuries occurring on or around horses, to examine the nature of protective clothing in relation to these injuries, and to compare our data with previously published work in this area. Patients were identified using the term "sports injury-horse riding" from the departmental database for one calendar year from February 2000. Data were collected regarding demographics, injuries, protective clothing, and outcome. The data were then analysed and compared with the previously published literature. 260 patients' records were analysed. The patients were mostly young (median age 26) and female (84.6%). The majority of patients had a single injury (88.8%). Seventeen per cent had an isolated head injury, all of which proved to be minor. Multiple injuries including the head accounted for 8.5% of all injuries. These again proved minor, bar one fatality where the helmet came off before impact. Upper limb injuries accounted for 29.2% of all injuries of which 61.8% sustained a fracture of which 36.2% were to the wrist. When compared with previous work the incidence and severity of head injury continues to decline while the relative number and severity of upper limb injuries increases. The majority of head injured riders are wearing approved helmets and sustaining only minor injury. There is currently no protective gear recommended for the upper limb and more specifically the wrist. This paper identifies the potential need for research and development of such protection.
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To characterise and provide nationally representative estimates of persons with non-fatal horse related injuries treated in American emergency departments. The National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) is a stratified probability sample comprising 66 hospitals. Data on injuries treated in these emergency departments are collected and reported. NEISS-AIP data on all types (horseback riding and otherwise) of non-fatal horse related injuries from 2001 to 2003 were analysed. An estimated 102,904 persons with non-fatal horse related injuries (35.7 per 100,000 population) were treated in American emergency departments each year from 2001 to 2003 inclusive. Non-fatal injury rates were higher for females (41.5 per 100,000) than for males (29.8 per 100,000). Most patients were injured while mounted on a horse (66.1%), commonly from falling or being thrown by the horse; while not mounted, injuries most often resulted from being kicked by the horse. The body parts most often injured were the head/neck region (23.2%), lower extremity (22.2%), and upper extremity (21.5%). The most common principal diagnoses were contusions/abrasions (31.4%) and fractures (25.2%). For each year that was studied, an estimated 11 502 people sustained traumatic brain injuries from horse related incidents. Overall, more than 11% of those injured were admitted to hospital. Horse related injuries are a public health concern not just for riders but for anyone in close contact with horses. Prevention programmes should target horseback riders and horse caregivers to promote helmet use and educate participants about horse behaviour, proper handling of horses, and safe riding practices.
Article
Context In the sport of horse racing, the position of the jockey and speed of the horse predispose the jockey to risk of injury. Objective To estimate rates of medically treated injuries among professional jockeys and identify patterns of injury events. Design Cross-sectional survey from data compiled by an insurance broker. Information on the cause of injury, location on the track, and body part injured was evaluated. Setting Official races at US professional racing facilities (n = 114) from January 1, 1993, through December 31, 1996. Participants A licensed jockey population of approximately 2700 persons. Main Outcome Measures Annual injury incidence rates per 1000 jockey-years, as well as injury type, cause, and location on the track. Results A total of 6545 injury events occurred during official races between 1993 and 1996 (606 per 1000 jockey-years). Nearly 1 in 5 injuries (18.8%) was to the jockey's head or neck. Other frequent sites included the leg (15.5%), foot/ankle (10.7%), back (10.7%), arm/hand (11.0%), and shoulder (9.6%). The most frequent location where injuries occurred was entering, within, or leaving the starting gate (35.1%), including 29.5% of head injuries, 39.8% of arm/hand injuries, and 52.0% of injuries to the leg/foot. Most head injuries resulted from being thrown from the horse (41.8%) or struck by the horse's head (23.2%). Being thrown from the horse was the cause of 55.1% of back and 49.6% of chest injuries. Conclusions Our data suggest that jockeys have a high injury rate. Efforts are needed to reduce the number of potential injury events on the track and to improve protective equipment so events do not lead to injury.
Article
Introduction Despite a number of injury prevention campaigns and interventions, horse riding continues to be a dangerous activity, resulting in more accidents per hour than motorcycling, skiing and football. Injuries are often serious, with one in four patients requiring admission to hospital. This study aims to describe the severity of equestrian-related injuries (ERIs) using both clinical parameters and patient-reported outcomes. Patients and Methods A retrospective study of all patients aged ≥ 18 years admitted to The Alfred Hospital between January 2003 and January 2008 with an ERI was performed. Specific clinical data were extracted from the medical record. In addition, a questionnaire was conducted identifying the details of the accident, the required recovery time and levels of ongoing pain and physical disability. Results During the study period 172 patients met the inclusion criteria. There were three deaths (2%). Eighty-two patients (48%) suffered head injuries. Forty-one patients (24%) were admitted to the ICU and 31 patients (18%) required mechanical ventilation. On discharge, 41 patients (24%) required transfer to a sub-acute rehabilitation facility. One-hundred-and-twenty-four patients (72%) completed the questionnaire. Thirty-nine respondents (31%) were not wearing a helmet. Among patients injured for more than 6 months, 38 (35%) still experienced moderate or severe pain or disability. Ninety-five patients had returned to work at the time of review, among which 47(50%) required longer than six months to recover, and 40 (42%) returned at a reduced capacity. Conclusions The clinical and patient-reported outcomes of ERIs requiring hospital admission are poor. Persistent pain and disability are common, even up to five years post-injury. A large proportion of patients required longer than six months to return to work and many return at a reduced capacity.
Article
Horse-riding is increasing in popularity. During 1971 and 1972 154 patients had horse-related injuries of sufficient severity to warrant admission to the Radcliffe Infirmary. The injuries sustained are more common and more severe than generally appreciated and are comparable to those sustained by motor-cyclists. Supervision of children is often insufficient and protective leg and head gear is commonly quite inadequate, even when worn.
Article
In a prospective study involving 110 injured equestrians, there were no noteworthy correlations between age, sex, or experience of the amateur riders and injury occurrence. Tack failure caused several injuries. Among fox hunters the incidence was related only to frequency of hunts. The most common severe injury was to the head, associated with lack of headgear. Fewer than 20% of the 110 riders used a protective helmet. There were four renal contusions and one bladder laceration. The most frequent injuries were fractures of the upper extremities. Wearing a good-quality protective helmet and checking tack are important for injury prevention. (JAMA 240:1881-1882, 1978)
Article
A group of experienced riders who qualified for the German riding badge 9.5 years ago answered a questionnaire pertaining to injuries during jumping, dressage and cross-country riding, as well as handling the horse. During riding 69% of the persons had had 187 injuries and while handling the horse 52% had had 124 injuries. Fractures and contusions were the most-frequent injuries; most riding injuries were located in the upper extremities and shoulder while handling mainly in the hands and feet. The number of injuries was comparable in jumping, dressage or cross-country riding. The time engaged in jumping was about one-third of the other types of riding, but the injuries were more severe. While handling the horse the number of injuries relative to the time spent during the activity were higher but less complicated. No change in safety precautions had been implemented by 67% of the persons injured. The injury rate for equestrians is relatively low both in handling the horse and during riding. The frequent fractures and contusions may be reduced by following the required safety regulations.
The aim of this study was to examine injury events and risk-factors among Swedish adult eventing athletes. A cross-sectional study design with retrospective recording of 1-year sports-specific exposure and injury data was used. The invited study population consisted of all members of the Swedish Equestrian Federation with eventing as their primary discipline (n = 513). The participation rate was 70.0%. The total 1-year injury prevalence was 26.6%; the specific 1-year prevalence of traumatic injury was 19.3% and of overuse injury 10.9%. The incidence of traumatic injury events was 0.54 injury events/1000 eventing hours (95% confidence interval (CI), 0.35-0.73 injury events/1000 eventing hours) for novices and 0.35 injury events/1000 eventing hours for qualified riders (95% CI, 0.21-0.49 injury events/1000 eventing hours). A total of 27.9% of the traumatic injury events led to severe injuries (causing more than 3 weeks absence from riding). Attitude to risk-taking was the only factor predicting an athlete becoming injured (p = 0.023), and qualification level was the only risk factor for additional injuries among injured riders (p = 0.003). Our results suggest that injury prevention programs in eventing should also give attention to overuse injuries and that care should be taken when eventing athletes are licensed into higher qualification groups.
Article
Equestrian sports continue to grow in popularity in the Unites States and abroad, with an estimated 30 million people riding horses annually in the United States alone. Approximately one in five of these riders will suffer a serious injury during their riding career, requiring medical care and potentially hospitalization. Riding carries with it an implicit risk of injury associated with the unpredictability of the animals, the rider's head being positioned approximately 9 feet off the ground, and traveling unrestrained at speeds up to 40 mph. This article reviews common equestrian injuries, epidemiology, mechanism of injury, risk factors, and prevention strategies, with an emphasis on the more dangerous aspects of the sport.
Article
The purpose of the present study was to investigate factors affecting the nature, characteristics, severity and outcome of horseback and horse care injuries in paediatric patients and to create guidelines for injury prevention. Detailed clinical records of 265 children sustained horse-riding related injuries have been analysed. Questionnaires were mailed to provide follow-up information for patients who have been treated in either Department of Paediatric Surgery in Pécs, Hungary, or Department of Paediatric Surgery in Graz, Austria between 1999 and 2003. Those 112 children (42%) who answered the questionnaire were included in the study and further analyses were performed. Female to male ratio of the 112 patients was 101/11. Trauma occurred during horseback riding accounted for 76.8% of all cases; these injuries represented more severe cases comparing to those which happened while handling a horse (23.2%). The mechanism as well as the localisation of injury displayed a close association with age. Prevention strategies targeting horse-related injuries at children should appreciate the age-dependent nature of injury as well as the fact that injury severity is not necessarily associated with the experience of the rider.
Article
Among the patients of Nordwestdeutsche Kieferklinik, the number of injuries in the oral and maxillofacial regions caused by horses has steadily increased from 1970 to 1975. In 6 years 22 accidents with the following causes were recorded: hit by horse's hoof (14 cases); fallen from horse's back (6 cases); bitten by horse (1 case); pushed by horse's head (1 case). Of 13 female patients, 6 had fallen from the horse's back, while nearly all men and boys were hit by the horse's hoof. Of the injured, 16 patients said they were horse back riders, 3 agricultural employees, and 3 were children. Injuries caused by hoofs were the most serious, because the full impact of the hoof hit a relatively small surface. For the most part, one side of the face was injured only, with the upper and the lower jaws being involved equally as often. In addition, soft tissue lacerations and cerebral concussions were frequently observed.
Article
Between 1959 and 1974 the number of registered riding accidents in West Germany increased by 344%, while all sport accidents in general increased only by 11% in the same time. This is due to the growing number of riders: the number of members of the largest riding community increased 387%. In England and Sweden the development seems to be similar. Two thirds of the 367 patients, treated after riding accidents in Heidberg General Hospital, Hamburg, were women, most of them teen agers or in their twenties. Most of the injuries involved the upper half of the body, especially the severe injuries and fractures: 21% involved the forearm; 20% elbow, upper arm, and shoulder, 10% the collar bone. The lower limbs contributed only 13% of the fractures. Vertebra fractures were rather common with 10.5%. Traumas of skull and brain were found in 13%, blunt abdominal injuries and urological injuries were rare. There were five cases treated in neurosurgery, one patient died. There are no typical riding injuries, but reported cases predominantly include the upper extremities and the head. Interviews included 212 patients who spoke about the circumstances and causes of their accident. We found that the likelihood of riding accidents decreased with age and training. More than half of all the patients called themselves beginners. In addition, the better trained had lighter injuries. Most of the accidents happened during free country riding, one third in the riding hall. Many accidents occurred during stable work (one out of seven), rather few in jumping and the military. One third of the inverviewed men and two thirds of the women thought their accident was avoidable. A large variety of reasons for the accidents were reported: incidental reasons like deer, rabbit holes, and cars were responsible in approx. 15% of the cases. Poor outfit only in three cases, in 10% it was the horse's fault, and in a majority of 60% it was the fault of either the rider or the teacher. In conclusion we can say that a sport with so many severe injuries cannot be called harmless. The most vital point for prevention is, aside from security outfits (caps. etc.), a thorough, safety conscious training.
Article
In a prospective study involving 110 injured equestrians, there were no noteworthy correlations between age, sex, or experience of the amateur riders and injury occurrence. Tack failure caused several injuries. Among fox hunters the incidence was related only to frequency of hunts. The most common severe injury was to the head, associated with lack of headgear. Fewer than 20% of the 110 riders used a protective helmet. There were four renal contusions and one bladder laceration. The most frequent injuries were fractures of the upper extremities. Wearing a good-quality protective helmet and checking tack are important for injury prevention.
Article
A prospective one-year study of horse-riding accidents was performed in an area with a very high frequency of amateur riding. Totally 174 patients with riding injuries were registered--66% children--making an incidence of only 0.7 per thousand riding occasions. However, many of these injuries were of a severe nature, one leading to death and 27 of the patients reporting persisting symptoms at follow-up one year after the accident. Eleven per cent of the accidents lead to cerebral injuries and 44% to fractures, mainly of the upper extremities. Eleven per cent required hospitalization and 17% operation under general anaesthesia. Clarification of the circumstances concerning the accidents indicated that many of the severe injuries could probably have been avoided by use of better safety equipment.
Article
We reviewed the English language scientific literature about equestrian injuries among children and young adults. All studies showed that more females than males were injured, with falls from horses being the most common cause of injury. Fractures were common, and head injuries were associated with the vast majority of deaths (72% to 78%) and hospitalizations (55% to 100%). Although the overall injury rate was low, equestrian athletes are at risk for serious injuries. Pediatricians should know the medical contraindications for participation in equestrian sports and encourage riders to obtain horse safety training and use protective headgear (helmets) approved by the American Society for Testing Materials when riding or working around horses. Pediatricians can play an active role in increasing public awareness of equestrian injuries and in reducing risk of injury.
Article
The most common location of horse-related injuries is the upper extremity (24% to 61%) with injuries to the lower extremity second in frequency (36% to 40%). The head and face sustain 20% of horse-related injuries. The most common type of injury is a soft tissue injury (92% to 1%), followed by a fracture (57% to 3%). Concussion is the third most common type of injury (63% to 2%). The most frequent cause of hospitalisation is concussion (38% to 4%) with fracture second. The most common injury which leaves residual impairment is injury to the central nervous system. The age at which most injury occurred is less than 21 years. In the latest NEISS report (1987–1988), injuries have decreased in the younger riders, but have increased in the older riders (above 24 years). More women are injured than men, but over the age of 44 years more men are injured than women, with the difference more marked in the 1987–1988 NEISS report. Previous horse-related injuries are reported frequently (37% to 25%). In mortality studies from Australia and the United States, head injuries caused the majority of deaths (78% and 60%), followed by chest injuries (9%). In the Australian study each sex had 50% of the deaths. In the United States, 60% were male, 40% female. Above the age of 24 years male deaths increasingly predominate, being 15 male deaths to 1 female above the age of 64. Concussion is divided into 3 divisions of severity which require different medical evaluation and treatment: mild in which rider is stunned or disoriented for a brief period; moderate in which there is loss of consciousness for less than 5 minutes; and severe in which there is a loss of consciousness for more than 5 minutes. Investigative need is cited in the areas of previous horse-related injury, lessons, experience vs knowledge, epilepsy, drowning, gender, deaths, safety helmets, stirrups, and body protectors. No horse is a safe horse; some are safer than others but the horse is a potentially lethal animal. Prevention of accidents and injuries is dependent upon using knowledge previously obtained from studying horse activities. Much more information is available than in the past through the medical studies that have been done and the recommendations made by these investigators. The medical community has a responsibility to educate the horse riding public and to participate in investigations requested by the horse organizations. The foremost requirement for riders is that secured certified protective headgear secured by a chin strap or harness be worn by all riders at all times when mounted.
Article
Riding accidents can be of a serious nature. Knowledge of risk factors is of essential value in the prevention of injuries. From the years 1969 through 1982 a series of 53 lethal riding injuries is analysed with reference to the rider, the horse, and the environment. Craniocerebral injuries dominate in this series, indicating the importance of adequately protecting helmets. Among the victims the female sex is dominating before the age of 25 and the males above this age. Older horses are less frequently involved in these accidents than younger ones. A long training period for riders under surveillance of a teacher is of outmost importance. Outdoor riding should be recommended only to experienced riders.
Article
Horse-riding is increasing in popularity. During 1971 and 1972 154 patients had horse-related injuries of sufficient severity to warrant admission to the Radcliffe Infirmary. The injuries sustained are more common and more severe than generally appreciated and are comparable to those sustained by motor-cyclists. Supervision of children is often insufficient and protective leg and head gear is commonly quite inadequate, even when worn.
Article
The fatalities associated with the riding and handling of horses in South Australia over the 11-year period 1973-1983 are reviewed. There were 18 deaths, including two sudden natural deaths in the saddle and one drowning. The 15 cases of horse-related trauma represent a death rate of approximately one per million population per annum. Thirteen of the deaths were the result of a head injury after a fall. Nine persons were not wearing protective headgear. The two principal groups at risk were male professional riders with a mean age of 32 years and female amateurs with a mean age of 19 years.
Article
A retrospective chart review was conducted to define the demographic and injury patterns of patients presenting to the emergency department (ED). The setting is a rural/small urban tertiary care center with approximately 40,000 visits per year. All patients presenting to the ED from January 1986 through December 1990 with equestrian-related injuries were enrolled in the study. Measurements included age, sex, mechanism of injury, injury or injuries diagnosed, admission to the hospital, morbidity, and mortality. A total of 142 patients met the inclusion criteria. The majority of injuries occurred when the patient fell from a horse. There were also a large number of injuries associated with handling the horse. Most injuries were minor, but 15% required hospital admission. There were no deaths. In conclusion, equestrian activities are associated with a risk of serious injury to both riders and handlers of horses. Education of both the public and primary care physicians should focus on injury prevention.
Article
Horse riding is a dangerous pastime with more accidents occurring per hour than during motor-cycling. Since a prospective survey of horse-related injuries conducted at a major centre in 1971-1972, equestrian groups and the medical profession have encouraged improvements in training and protective riding wear. By conducting a similar study at the same centre 20 years later we hoped to assess the effects of these measures on the pattern of injuries resulting from contact with horses. Patient and injury details were recorded prospectively for all those presenting to the Accident Service at Oxford during the whole of 1991. Total admissions fell by 46 per cent on average. Most of the decrease was due to a near fivefold fall in those admitted with head injuries (P < 0.001). A reduction in the severity of such injuries was associated with an increased use of riding helmets. However, the most commonly injured group remained amateur young female riders suggesting the need for increasing awareness and training of this group. In seven cases, severe digital injuries were caused by the habit of entwining reins around the fingers. This practice should be discouraged. Up to 12 per cent of all injuries might have been prevented if adequate footwear had been worn.
Article
The medical and sports literature databases were searched for equestrian sports-related injury published in English since 1980, together with conference abstracts and discussions with equestrian sporting bodies. This literature was critically reviewed, with emphasis on measures to prevent or control injury i.e. countermeasures. While there is considerable literature available on the epidemiology of injury incurred in most equestrian sports, there is little on the prevention of these injuries. Case-control or other studies evaluating the effectiveness of the countermeasures suggested by authors do not seem to exist. There is a good body of epidemiology that supports the proper use of approved helmets as a means of preventing injury in these sports. However, protective helmets do not always prevent injury as expected, and many riders do not choose to wear them because of perceived poor design. The search for the ideal equestrian helmet should continue. Ideally the effectiveness of helmets should be assessed scientifically. Among the other countermeasures discussed are the use of rules and regulations for conduct of events, knowledge of horse behaviour, well-conducted lessons, contraindicated medical conditions, public education, rider education, appropriate equipment and clothing, the riding environment, rider experience, safety stirrups, body protectors, falling techniques, and first aid measures. Even though the injury rate for equestrians is relatively low when compared with other sports, the injuries that are incurred are usually severe. prevention is often difficult because the behaviour of the horse is unpredictable. Countermeasures used for prevention should be evaluated for the effectiveness to reduce the frequency and severity of injuries to equestrians.
Article
Horse riding is a hazardous pastime, with a number of studies documenting high rates of injury and death among horse riders in general. This study focuses on the injury experience of cross country event riders, a high risk subset of horse riders. Injury data were collected at a series of 35 equestrian events in South Australia from 1990 to 1998. Injury rates were found to be especially high among event riders, with frequent falls, injuries, and even deaths. The highest injury rates were among the riders competing at the highest levels. There is a need for skilled emergency medical services at equestrian events.
Article
To determine the demographics of hospital admissions and mortality associated with equestrian activities in the 33,000 riders in British Columbia (BC). Analysis of admission data from the Ministry of Health for the years 1991-96, review of information obtained from the Office of the Chief Coroner, and comparison of data from Canadian Hospitals Injury Reporting and Prevention Program. The mean number of admissions per year was 390. Head injury was the most common cause of admission to hospital (20%) in BC. Females most often required admission (62%). Teenagers and children have a higher incidence of head injuries than the general population. The injury rate was 0.49/1000 hours of riding. There were three deaths per year, 1/10,000 riders; 60% were caused by head injury and females predominated. Head injuries and other serious injuries occur with equestrian activities and it is important for doctors, instructors, and parents to promote the use of appropriate safety equipment, including helmets, especially for children.
Article
To investigate the demographic details and patterns of injuries related to horse handling, we reviewed 637 horse-related injuries in 581 stable- or stud-workers in a representative area of thoroughbred stabling in Japan. We found that (1) injuries occurred most frequently in a group of a relatively young workers, with a seasonal variation; (2) the principal mechanism of injury was kicks, which accounted for 39.2% of all injuries, including 11 serious and one lethal visceral injuries; (3) the upper half of the body was more frequently involved than the lower half; and (4) the peripheral bones (hand and foot) and the ribs accounted for more than half of 148 fractures. These findings are distinct from those in horse-riding injuries reported in the literature and emphasize the importance in developing preventive strategies specifically for workers in horse stables.
Article
Horseback riding is an increasingly popular activity among today's youth, providing them with the opportunity to learn responsibility and respect for animals. However, it can also be associated with severe injury, of which many physicians are unaware. In 2002, there were an estimated 13,400 emergency department visits nationwide for horse-related injuries among children younger than 15 years. When using a severity score to compare it with other childhood injuries, equestrian-related injury ranked second only to pedestrians being struck by a car, and had a higher score than all terrain vehicle, bicycle, and passenger motor vehicle crash injuries. Most serious injuries occur when a rider is thrown from a horse, which is often accompanied by being dragged or crushed by the horse. However, hoof kick injuries to an unmounted child represent about 30% of horse-related injuries and may result in more severe injury. Head injury is the injury most likely to result in hospitalization or death. The effectiveness of helmets in preventing serious head injury in horse-related accidents has been very well established. Recommendations for the prevention of horse-related injury include requiring helmet use on and near a horse, use of safety stirrups to prevent drag injury, matching rider skill with the appropriate horse, and providing close adult supervision.
Article
The literature contains many studies on the types of injuries sustained in horseback riding incidents. Most advocate the use of equestrian helmets to prevent head trauma. However, information is limited on other specific prevention strategies. A 4-year, retrospective, and prospective review of medical records pertaining to horse-related injuries in a southwestern Colorado hospital yielded a sample of 85 patients who had been injured while riding or tending to horses. In addition to the record review, patients were interviewed during ED discharge, inpatient treatment, or in a follow-up telephone call to determine the types, causes, and mechanisms of injuries, and the circumstances surrounding the incidents. Operators of 7 guest ranches and outfitters within a 30-mile radius of the hospital plus 3 ranches in Oklahoma and an additional ranch in Colorado were contacted with the study results and suggestions for injury prevention. Patients ranged in age from 2 to 77 years. Fifty-five percent were inexperienced or beginner riders, 10% were novice riders, and 35% were experienced riders. Seventy percent were injured during recreational pursuits. The average Injury Severity Score for all patients was 8.5, with an average length of stay of 72 hours. Injuries were related to rider inexperience, equipment problems, or unpredictable horse behavior. Thirty-eight percent of the horse-related injuries were preventable. All operators of the guest ranches and outfitters were receptive to hearing or reading the study information. It is hoped that raising awareness and providing suggestions related to the screening of riders, prevention of injuries, and safety measures may decrease the numbers of horse-related injuries.
Article
This chapter reviews the current evidence for the epidemiology of pediatric equestrian injuries. The relevant literature was searched through the use of MEDLINE (1966-2004) and SPORT DISCUS (1975-2004) searches, hand searches of journals and reference lists and discussions with experts and sporting organizations worldwide. Keywords and Mesh headings used in all searches included horse racing, children, pediatric injuries, sports injuries, equestrian injuries and sports trauma. Limited data exist on the epidemiology of pediatric equestrian injuries. Most studies note the high preponderance of females with a peak incidence at approximately 14 years of age. This is likely to reflect the higher rate of female riders. The two most common horse riding-related injuries are long bone fractures and head injury. Although most injuries occur during recreational riding, approximately 15% of injuries occur in nonriding activities such as feeding, handling, shoeing and saddling. While there is little knowledge of injury demographics or the efficacy of prevention countermeasures in this field, it is likely that injuries will continue to occur. The major challenge in reducing pediatric equestrian injuries is the formal scientific demonstration that the various proposed injury prevention measures are effective. With the majority of equestrian injuries happening during unsupervised leisure riding, the prospect of injury prevention is limited.
Article
The aim of this study was to compile specific foot injuries occurring in pediatric patients that result from equestrian sports and to highlight the importance of wearing adequate riding boots to protect the feet. During a 12-year period, 258 children were admitted to Children's Hospital of Geneva for injuries resulting from horseback riding. Amongst these children, 8 sustained foot lesions that required hospital admission. Four children had compression-type fractures of the cuboid (nutcracker fracture of the cuboid) associated with other complex midfoot fractures, 2 had Lisfranc fracture dislocations, 1 had a fracture of the talus with associated intern malleolar fracture, and the last had a fracture of the 5 metatarsals with lateral displacement. All the noted lesions complied with the same traumatic mechanisms. The horse fell on the patient, and the child's foot, entrapped in the stirrup, was caught in between the animal and the ground. The forefoot was bent by indirect violence in abduction by the stirrup, which acted as a fulcrum. Serious foot injuries may occur in children during equestrian activities. These lesions may be very disabling. Therefore, it is important for doctors, instructors, and parents to promote the use of appropriate safety equipment, including strengthened riding boots and safety stirrups.
Article
Equestrian injury is commonly seen at trauma centers and the severity of injury is often high. We sought to determine the risk, incidence, and the influence of skill and experience on injury during horse-related activity (HRA). Members of horse clubs and individual equestrians in a three-state region (Oregon, Washington, and Idaho) were recruited via mailings and community advertisements to take a survey regarding their horse contact time and injuries over their entire riding career. Serious injury (SI) was defined by hospitalization, surgery, or long-term disability. There were 679 equestrians with a median age of 44 years who reported a median of 20 hours of HRA per month with a mean of 24 years (1 to 75 years) experience. The cumulative risk of any injury (AI) was 81% and of SI was 21%. The incidence of AI and SI were 1.6 +/- 0.1 (SE) and 0.26 +/- 0.02 per 10,000 hours, respectively. The incidence, per 10,000 hours, of AI was 7.6 +/- 2.7, 2.4 +/- 0.2, 1.5 +/- 0.1, and 1.0 +/- 0.1 at novice, intermediate, advanced, and professional levels, respectively (p < 0.001, analysis of variance [ANOVA]) and of SI was 1.03 +/- 0.52, 0.38 +/- 0.06, 0.21 +/- 0.03, and 0.19 +/- 0.04 at the respective skill levels (p < 0.001, ANOVA). There was a sharp decline in incidence of injury between 18 and 100 hours of experience. Helmet use was 74%, 61%, 58%, and 59% at the respective skill levels (NS, chi). One in five equestrians will be seriously injured during their riding career. Novice riders experienced a three-fold greater incidence of injury over intermediates, a five-fold greater incidence over advanced riders, and nearly eight-fold greater incidence over professional equestrians. Approximately 100 hours of experience are required to achieve a substantial decline in injury. These findings suggest that equestrian injury prevention efforts need more attention and should focus on novice equestrians.
Article
Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). Injuries included the chest (54%), head (48%), abdomen (22%), and extremities (17%). Forty-five percent required surgery. Survey results (55%) indicated that riders and horses were well trained, with a 47% recidivism rate. Only 9% of patients wore helmets, however, 64% believed the accident was preventable. Chest trauma previously has been underappreciated. This injury pattern may be a result of significant rider experience. Helmet and vest use will be targeted in future injury prevention strategies.
Unfälle beim Pferdesport. Unfallhergang, Verletzungen und Prävention
  • G Giebel
  • K Braun
  • W Mittelmeier
Giebel G, Braun K, Mittelmeier W. Unfälle beim Pferdesport. Unfallhergang, Verletzungen und Prävention. Hefte Z Unfallchir. 1994;244:151-5.
  • K Steinbrück
  • Wirbelsäulenverletzungen Beim Reiten
Common injuries in horseback riding; a review
  • D Bixby-Hammett
  • W Brooks
Bixby-Hammett D, Brooks W. Common injuries in horseback riding; a review. Sports Med. 1990;9:36-47.
Der tödliche Reitunfall
  • E Kricke
Kricke E. Der tödliche Reitunfall. Unfallheilkunde. 1980;83:606-8.