APSA Paper
Equestrian injuries in children

https://doi.org/10.1016/j.jpedsurg.2008.10.025Get rights and content

Abstract

Purpose

Equestrian activities are regarded by some as high-risk sports, and our recent experience suggested this to be true. We undertook this study to review our experience with pediatric equestrian injuries.

Methods

After institutional review board approval, we reviewed emergency department and hospital admissions for children 0 to 18 years, with equestrian trauma, over an 11-year period.

Results

There were 164 encounters with 135 girls and 29 boys. Most injuries (82%) occurred after falling or being thrown from the animal, and only 12% occurred during jumping or rodeo competitions. The remaining injuries were secondary to being trampled, kicked, or trapped under the animal. Eighty-seven children required hospital admission. Lacerations and contusions (58%) or orthopedic injuries (31%) were most common in the emergency department cohort. In the admission cohort, injury sites included orthopedic (34%), head (23%), abdomen (21%), and chest (11%). Multiple injuries occurred in 13%. A significant number of children required surgical interventions, including 19 orthopedic procedures, 4 laparotomies, 3 facial reconstructions, and 2 craniotomies. The average length of stay was nearly 4 days, with 60% of the children requiring intensive care admission. There were no deaths. One child was discharged to rehab, the rest were sent home.

Conclusions

In our experience, more than one third of the children admitted after sustaining injuries in horse-related sports required surgical interventions. Children participating in equestrian activities are at risk for substantial injury, and pediatric care providers must maintain a high index of suspicion when evaluating these children.

Section snippets

Methods

Approval for this study was obtained from the institutional review board. Both the hospital and pediatric surgery databases were queried for all pediatric patients seen at our institution over an 11-year period who were younger than 18 years and had sustained equestrian trauma (International Classification of Diseases, Ninth Revision, Clinical Modification code E828). All children were evaluated by the pediatric surgery or trauma surgery services. A retrospective review of the hospital and

Patient demographics

Over the 11-year period, there were 164 patient emergency department (ED) encounters. There were 135 girls and 29 boys with a median age of 12 years (range, 3-18 years). Most injuries (82%) occurred during recreational activities, whereas 12% of injuries were sustained during participation in competitive or supervised events such as barrel racing, jumping, rodeo, or riding lessons. The remaining injuries (6%) resulted after being kicked, trampled, or trapped under the animal. Of the 164

Discussion

Trauma remains the leading cause of death in children in the United States. Horseback riding is considered to be a dangerous activity, and our current experience confirms this belief. These large and unpredictable animals are able to reach speeds of 40 mph and can kick with 1 ton of force [6]. Therefore, in areas where equestrian-related sports and recreation is common, there is great need for safety education and prevention measures to reduce trauma associated with these activities. We

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Presented at the 39th annual meeting of the American Pediatric Surgical Association, Phoenix, AZ, May 27-June 1, 2008.

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