Article

Dogs and Orthopaedic Injuries: Is There a Correlation With Breed?

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Objectives: To identify the incidence of orthopaedic injuries secondary to dog bites, determine the responsible breeds and assess the severity of injury by dog breed. Design: Retrospective. Setting: Single Level 1 trauma center. Patients: Ninety-five patients treated for a dog bite that resulted in an orthopaedic injury between January 2010 and July 2016. Intervention: Patients were treated according to their specific orthopaedic injury. Main outcome measurements: Dog breed and type of orthopaedic injury. Results: Thirty-nine percent of all dog-bite related emergency department visits resulted in an orthopaedic injury requiring specialist treatment. Of the 95 patients, 50% were the result of a pit bull terrier bite and 22% by a law enforcement dog. A total of 32% were attacked by multiple dogs. There was a 51% incidence of severe injury (amputation or fracture) with a significant association to breed. Conclusions: Thirty-nine percent of all dog-bite related emergency department visits at our facility resulted in an injury requiring orthopaedic treatment. Pit bull terrier bites were responsible for a significantly higher number of orthopaedic injuries and resulted in an amputation and/or bony injury in 66% of patients treated, while bites from law enforcement dogs and other breeds were less associated with severe injuries. Level of evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... There is a paucity of literature on K-9 dog bites. [15][16][17][18][19][20] Snyder and Pentecost in 1990 18 noted that 46 of 48 angiograms performed for dog bites were due to K-9 events, suggesting that K-9 dog bites may be more serious than other dog bite injuries. Pineda et al., in 1996 16 reviewed injuries due to K-9 dog bites at the Los Angeles County Hospital and selected four cases to describe the scope of injury and complications associated with K-9 dog bites. ...
... Meade in 2000 17 compared the injuries between K-9 and domestic dog bites from the same Los Angeles area. Brice et al. 20 noted that 21 of 95 (22%) dog bite victims requiring orthopaedic consultation seen at a Level I trauma center in Fresno, California, were due to K-9s, but lower than the 50% due to a non K-9 pit bull terrier. However, there are no studies of K-9 dog bites encompassing the entire United States. ...
... [10][11][12][13]25,26 It is also likely due to the fact that K-9s are often trained to preferentially bite the extremities. 27 Brice et al. 20 in Fresno, California noted that K-9 bites were less serious than non K-9 pit bull bites (24% vs 66% having a serious injury). They surmise this was due to the training and suspect apprehension techniques use in the K-9 teams, as well as the ability of the police officer to ultimately restrain the dog compared to the pit bull terrier attacks. ...
Article
Background There is sparse literature regarding K-9 (legal intervention) dog bites. It was the purpose of this study to analyze the demographics of K-9 dog bites using a national data base. Methods This was a retrospective study of prospectively collected data from National Electronic Injury Surveillance System - All Injury Program for years 2005–2013. Patients with dog bites were identified and those due to legal intervention were analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software. A p < 0.05 was considered statistically significant. Results There were an estimated 32, 951 K-9 dog bite ED visits, accounting for 1.1% of all ED dog bite visits. The K-9 group was nearly all male (95.0 vs 52.1%) and more commonly Black (42.0 vs 13.0%) compared to the non K-9 group. Bites to the head/neck and upper extremity were less frequent and lower extremity bites more frequent in the K-9 group; K-9 bites more commonly occurred outside the home. Within the K-9 group, the proportion of White patients increased with increasing age and smaller hospital size. Patients seen in small and medium size hospitals were in the middle age ranges, while those in the very young and >64 years of age were only seen at large hospitals. The average annual incidence of K-9 dog bites seen in the ED for US was 2.43 per 100,000 males with no changes over time. Conclusions In the US, 1.1% of all ED visits for dog bites are due to K-9 intervention with no change in incidence, even though this study spanned the time when it was encouraged to change K-9 intervention; from “find and bite” to “find and bark”. The K-9 dog bite patient is nearly always male, more commonly Black, occurred away from home, and has a 3.7% hospital admission rate. Bites to the head/neck are less common compared to the non K-9 dog bite group.
Article
Background: Dog bite injuries cause significant preventable patient morbidity and health care expenditure in children. This study aimed to characterize the patient and healthcare burden related to pediatric dog bite injuries at a level 1 trauma center. Methods: This is a retrospective review of 356 pediatric patients who presented to Virginia Commonwealth University Pediatric Emergency Department between July 2007 and August 2017 after sustaining dog bite injuries. Demographic information, injury details, management, outcomes, and financial information were analyzed. Results: Most pediatric dog bite injuries afflicted male children (55.6%), ages 6 to 12 years (45.7%), by a household dog (36.2%). The most common offending breed was a pit bull or pit bull mix (53.0%). Infants and grade schoolers were more likely to sustain bites to the head/face (P = 0.001). Usual management consisted of primary repair (75.9%), whereas approximately 25% of the patients required advanced reconstructive techniques. Most patients healed uneventfully, but prolonged antibiotics, additional wound care, or procedures were necessary in 8.4% of the patients. Hospital charges per patient averaged US $8830.70 and tended to be higher in the younger age groups. Insurance status was statistically associated with use of conscious sedation, surgical consult placement, and surgical repair. Conclusions: Although most pediatric dog bite injuries in this study healed uneventfully from primary management in the emergency department, 25% required additional interventions. Furthermore, patient care for these injuries was associated with significant but potentially avoidable personal and financial burden to families. Our data reflect a need for safety education on animal care, behavior, and interaction.
Article
This contribution aimed to highlight the importance of the legal framework on human-dog interactions to better understand the “more‐than‐human cosmopolitanism”. Thus, it gives insight into the never-ending debate of how we can share the living space with other forms of life. The study acknowledged the inconsistencies between community members’ and experts’ opinions on the best methods to prevent dogs’ attacks, the imperative to consider concerns for animal welfare and public safety while improving the legitimacy of different implemented measures. The seriousness of the dog control problem determined the enactment of laws to limit or ban dogs purely on their breed/type. The study explores Romanian citizens beliefs regarding law labeled “dangerous” dogs within the context of Romanian breed-specific legislation (Governmental Emergency Ordinance No. 55 of 2002). An overwhelming majority of respondents considered that a dog’s dangerousness must be assessed individually, according to each specimen’s characteristics, and regardless of the breed/type to which it belongs. A significant percentage of people were unaware of the legal regime in place for “dangerous” dog breeds. Responsible dog ownership intertwined with learning to care could solve the societal annoyance of “blacklisted” dog breeds/type.
Article
Introduction: We hypothesized that imaging is overused in the initial workup of dog bite patients. To reduce radiation exposure, we aim to determine which circumstances surrounding dog bites, patient population, and injury patterns would necessitate imaging studies for management. Methods: A retrospective review was performed on all patients presenting with dog bites to our level I pediatric trauma center between 2013 and 2015. Data collected included: circumstances surrounding the injury, patient demographics, injuries, and imaging studies performed. Our analysis focused on maxillofacial and head CT scans, and plain radiographic studies of the limbs, hands, and feet. Imaging studies were considered positive if there was evidence of bony injury. Results: We identified 615 patients with dog bites, with 114 patients having had at least one imaging study performed (a total of 145 imaging studies to analyze). Only 13 (11%) patients had a positive study. In the CT scan group, 6 (22.2%) of 27 studies were positive. In the plain radiographic group, 7 (5.9%) of 118 studies were positive. Conclusions: Our review indicates that imaging studies are overused in the initial workup of these patients, and the majority of these studies are negative. This study confirms that it is feasible to institute guidelines for ordering imaging studies in dog bite patients. This will ultimately reduce radiation exposure and the cost of care for these injuries.
Article
Se realizó un estudio retrospectivo de patologías músculo esqueléticas en perros en el Centro Veterinario Alemán Kleintierklinik de la Ciudad de San Pedro de la Paz, Chile, en el período comprendido entre septiembre del año 2014 a junio del año 2017. Del total de las 2000 fichas clínicas analizadas, 144 fichas presentaban pacientes con algún problema en el sistema músculo esquelético. Las patologías músculo esqueléticas con mayor incidencia fueron las fracturas (40, 27.8%), luxación patelar (31, 21.5%), ruptura del ligamento cruzado craneal (25, 17.4%) y displasia de cadera (23, 15.8%). Los machos, los de razas puras y los adultos fueron significativamente más afectados por las patologías musculoesqueléticas.
Article
Each year, approximately 4.7 million Americans sustain dog bites, the majority of which occur in children. In response to this alarming trend, injury prevention programs across the country have focused efforts on preventing dog bites in children. However, little attention has been given to non-bite dog-related injuries, and to date, no data have been presented on this type of injury in the western literature. After Institutional Review Board approval (IRB No. 07100185) was obtained, data from the trauma registry for all children (ages, 0-20 years) admitted to our Level I pediatric trauma center were evaluated from 2001 to 2007. Information regarding dog-related injuries was obtained. Data were divided into injuries related to bites and non-bites. Demographics, injury pattern, and outcome were evaluated. Descriptive statistics, Student's t test, and Fisher's exact/χ analyses were preformed. Over the 6-year period reviewed, 191 (2%) children were admitted to the Benedum Trauma Program for dog-related injuries. Thirty-four (18%) children sustained non-bite-related injuries while the remainder sustained bite/scratch injuries. Twenty-six (76%) of the children sustained injuries directly due to contact with dogs; four (12%) of them were injured after falling while being carried by adults who either tripped over a dog or were pushed by a dog. The remaining four (12%) children sustained injuries while colliding with dogs while on motorized and/or nonmotorized vehicles. Abrasions/lacerations and head injury occurred most frequently, followed by extremity fractures, particularly of the femur. Children injured by non-bite-related mechanisms were more severely injured than those sustained a bite, although the Injury Severity Score in both groups was low. Dog bites have been recognized around the world as a substantial public health problem particularly in children. In our experience, we have seen that non-bite-related injuries should not be ignored. The injuries seen in this subset of children are the result of being struck or pushed, resulting in multiple, potentially severe injuries. These data underscore the unpredictable nature of animals and the need for adult supervision when animals and children interact.
Article
We performed this study to determine the associated injuries after dog attacks and determine the incidence of vascular injury (VI) and potential associated factors. The registry at our Level I center was queried for admissions after dog bites between January 1,1992 and June 30, 2008. Demographic, injury, and outcome data were studied. We examined associations with VI. There were 86 eligible patients. Most were male (57, 66.3%). Mean age was 34.1 (+/- 20.1). Mean injury severity score was 3.9 (+/- 4.3). The most common serious injury was upper extremity fracture and/or dislocation (26, 30.2%), followed by VI (10, 11.6%) to the extremities (8, 9.3%) and neck (2, 2.3%). There were 44 (51.2%) operative cases including 28 (32.6%) wound debridements and 22 (25.6%) orthopedic interventions. Nine (10.5%) VI patients required operation. Mean length of stay was 5.7 (+/- 5.9) days. There were two (2.3%) deaths. Both were unrelated to the attack. No studied variable reliably predicted VI. Many patients admitted after dog attacks will require an operative intervention and several will harbor a VI. The presence of VI is unpredictable, lacking reliable associated patient and admission factors. A high index of suspicion is required in the evaluation of patients involved in dog attacks.
Article
To quantify the number of individuals bitten, the number of bites per patient, and the types of injuries and complications caused by law enforcement K-9 dog bites treated in the Jail Ward Emergency Department of the Los Angeles County-University of Southern California Medical Center. These variables were compared before and after a change in K-9 police policy from the "bite-and-hold" to the "find-and-bark" technique or stricter controls were instituted over the K-9 teams. A retrospective chart review of all patients in police custody with K-9 dog bites who presented to the Jail Ward ED between January 1, 1988, and December 31, 1995, was conducted. Demographic data of patients with K-9 dog bites, the number and location of bites, complications, procedures performed, and management of bites were recorded and compared between the periods 1988-1991 (before the policy changes) and 1992-1995 (after the changes). Between 1988 and 1995 790 in-custody patients were treated for K-9 dog bites in the Jail Ward ED; 705 charts were available for review. Nearly all the patients (98.6%) were male, with a mean age of 25; 85.0% were Hispanic or black. More than half (57.2%) sustained three or more bites, mainly to the extremities. Complications ensued in 19.3%: vascular in 7.0%, infection in 5.0%, fracture or cortical violation in 4.0%, nerve injury in 1.9%, and tendon injury in 1.1%. Half (49.9%) were hospitalized, with a median stay of 3 days. After the change in K-9 policy, the number of patients with K-9 dogs bites presenting to the Jail Ward ED decreased from 639 (1988-1991) to 66 (1992-1995). The proportion of patients who sustained three or more bites decreased from 58.4% to 45.5%. The rate of vascular complications decreased from 7.5% to 1.6%, the rate of fractures decreased from 2.4% to 0, and the rate of cortical violations increased from 1.4% to 6.3%. The proportion of patients hospitalized decreased from 52.0% to 33.8%. K-9 dog bites are associated with significant injuries and complications. In this study, changes in law enforcement K-9 policy contributed to a significant decrease in the overall number of individuals bitten, the number of injuries and complications, and the proportion of patients hospitalized.