title: Mechanisms and patterns of injuries related to large animals.
abstract: BACKGROUND
  Injuries from encounters with large animals represent a significant health risk for rural communities. We evaluated our regional trauma centers' experience with large-animal injuries to determine whether certain mechanisms and patterns of injury predicted either major head/craniofacial or torso (chest/abdomen/pelvis) trauma.
  
  
  METHODS
  The hospital courses of 145 patients with injuries related to large animals were reviewed retrospectively to determine patterns of injury, specific injury mechanisms, species-specific injuries, and predictors of multiple body region trauma.
  
  
  RESULTS
  Seventy-nine patients (55%) were injured by horses, 47 patients (32%) by bulls, 16 patients (11%) by cows, and 3 patients (2%) by wild animal attacks. The predominant species-specific mechanisms of injury were falls (horses), tramplings (bulls), and kicks (cows). Brain/craniofacial injuries were most common from horse-related encounters (32%), whereas bull and cow encounters usually resulted in torso injuries (45% and 56%, respectively). Multiple body region injuries occurred in 32% of patients. Fractures of the upper extremities were more often associated with torso and head/craniofacial injuries (48%) than lower extremity injuries (17%) (p = 0.02).
  
  
  CONCLUSIONS
  Large animal injuries frequently involve multiple body regions with species-specific mechanisms. Upper extremity injuries are associated with a significantly higher percentage of torso and head/craniofacial injuries, which may have implications for field triage.
authors.affiliation: Department of Surgery, East Texas Medical Center, Tyler, USA. ettrauma@ballistic.com
authors.forename: S
authors.initials: S
authors.lastname: Norwood
authors.forename: C
authors.initials: C
authors.lastname: McAuley
authors.forename: V L
authors.initials: VL
authors.lastname: Vallina
authors.forename: L G
authors.initials: LG
authors.lastname: Fernandez
authors.forename: J W
authors.initials: JW
authors.lastname: McLarty
authors.forename: G
authors.initials: G
authors.lastname: Goodfried
mesh_terms: D000328:Adult; D000818:Animals; D000835:Animals, Wild; D002417:Cattle; D006259:Craniocerebral Trauma / Q000209:etiology; D005151:Facial Injuries / Q000209:etiology; D005260:Female; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000209:etiology; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*