On and off the horse: mechanisms and patterns of injury in mounted and unmounted equestrians.
BACKGROUND
The purpose of this study is to determine whether discrepant patterns of horse-related trauma exist in mounted vs. unmounted equestrians from a single Level I trauma center to guide awareness of injury prevention.


METHODS
Retrospective data were collected from the University of Kentucky Trauma Registry for patients admitted with horse-related injuries between January 2003 and December 2007 (n=284). Injuries incurred while mounted were compared with those incurred while unmounted.


RESULTS
Of 284 patients, 145 (51%) subjects were male with an average age of 37.2 years (S.D. 17.2). Most injuries occurred due to falling off while riding (54%) or kick (22%), resulting in extremity fracture (33%) and head injury (27%). Mounted equestrians more commonly incurred injury to the chest and lower extremity while unmounted equestrians incurred injury to the face and abdomen. Head trauma frequency was equal between mounted and unmounted equestrians. There were 3 deaths, 2 of which were due to severe head injury from a kick. Helmet use was confirmed in only 12 cases (6%).


CONCLUSIONS
This evaluation of trauma in mounted vs. unmounted equestrians indicates different patterns of injury, contributing to the growing body of literature in this field. We find interaction with horses to be dangerous to both mounted and unmounted equestrians. Intervention with increased safety equipment practice should include helmet usage while on and off the horse.
General Surgery Residency Program, University of Kentucky College of Medicine, Lexington, KY, USA. Electronic address: sam.carmichael@uky.edu.
Samuel P
SP
Carmichael
General Surgery Residency Program, University of Kentucky College of Medicine, Lexington, KY, USA.
Daniel L
DL
Davenport
Department of Surgery, Section of Acute Care Surgery and Trauma, University of Kentucky College of Medicine, Lexington, KY, USA.
Paul A
PA
Kearney
Department of Surgery, Section of Acute Care Surgery and Trauma, University of Kentucky College of Medicine, Lexington, KY, USA.
Andrew C
AC
Bernard
D000007:Abdominal Injuries / Q000453:epidemiology / Q000517:prevention & control*; D000056:Accident Prevention; D000059:Accidents; D000328:Adult; D000818:Animals; D001265:Athletic Injuries / Q000453:epidemiology / Q000517:prevention & control*; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000517:prevention & control*; D005151:Facial Injuries / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control*; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006736:Horses; D006801:Humans; D008297:Male; D011482:Protective Devices / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000517:prevention & control*
Equitation; Head injury; Safety equipment; Trauma