title: Pattern of equestrian injuries presenting to a Sydney teaching hospital.
abstract: BACKGROUND
  Equestrian activities are associated with a high rate of injury. Attempts to reduce the incidence and severity of injury require accurate characterization of risk factors and pattern of injury. The present study was performed to analyse the injuries seen at an Australian centre where a large number of equestrian injuries present.
  
  
  METHODS
  Data were collected prospectively over a 3 year period on all equestrian injuries presenting to the Prince of Wales -Hospital complex. These data were compared against and combined with retrospectively collected data over the preceding 3 years at the same centre.
  
  
  RESULTS
  Two hundred and twenty-one injured equestrians presented (181 consented) in the prospective period of the study, and 208 presented in the retrospective period. Overall, 81% of riders were wearing a helmet at the time of their injury. Helmet use was associated with a significantly lower admission rate (27% vs 55%; P < 0.0001, from combined data). Recreational equestrians had a higher admission rate than professional equestrians, and had a significantly higher head and spine injury rate than the professional group. Rate of helmet use increased from 72% in the retrospective group to 91% in the more recent prospective group, and total admissions decreased from 43% to 14%.
  
  
  CONCLUSIONS
  Significant and serious injuries are associated with equestrian activities, with the higher risk group being recreational equestrians, and riders not using a helmet. The pattern of injury favours head and spine in recreational and non-helmeted riders, and extremities for professional and helmeted riders. Helmet use is still not universal among riders, although an increase in its use may be contributing to an overall reduction in admission rate. Facial and spinal injuries still occurred in helmeted patients.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Lim
authors.forename: Vikram
authors.initials: V
authors.lastname: Puttaswamy
authors.forename: Marcello
authors.initials: M
authors.lastname: Gizzi
authors.forename: Linda
authors.initials: L
authors.lastname: Christie
authors.forename: William
authors.initials: W
authors.lastname: Croker
authors.forename: Philip
authors.initials: P
authors.lastname: Crowe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001265:Athletic Injuries / Q000453:epidemiology*; D001315:Australia; D002648:Child; D002675:Child, Preschool; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006736:Horses; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011998:Recreation; D012189:Retrospective Studies; D012307:Risk Factors