A 12-year review of equestrian related injuries at a major trauma centre in South Africa.

Overview

• This study reviews equestrian-related injuries treated over 12 years at a major trauma center in South Africa.
• It analyzes the types of injuries, patient demographics, mechanisms of injury, treatment methods, complications, and outcomes.

Study Background and Purpose

• There are limited studies specifically focusing on equestrian injuries in the South African population.
• The aim was to understand the spectrum of injuries and patient profiles at state-funded trauma centers in South Africa, helping to inform safety and treatment practices.

Methods

• Retrospective analysis spanning 12 years from July 2012 to February 2025.
• Included all patients treated for equestrian-related injuries at a major trauma center.
• Collected data on patient demographics, injury type, severity, treatment approaches, complications, and outcomes.

Patient Demographics and Injury Characteristics

• Total patients included: 82.
• Gender: 83% male.
• Median age: 17 years, indicating a predominantly young patient population.
• Median Injury Severity Score (ISS): 9, showing moderate injury severity on average.

Mechanism of Injury

• Falls were the most common cause (41 patients).
• Being kicked by the horse was the next most frequent mechanism (38 patients).
• Other mechanisms recorded included trampling (2) and being dragged (1).
• This distribution emphasizes the high risk posed by falls and direct impact from the horse.

Injury Patterns and Affected Regions

• Most commonly injured areas were:
• Head and neck (49 cases).
• Face (29 cases).
• Chest (17 cases).
• These findings illustrate the vulnerability of the upper body and head during horse-related accidents.

Treatment and Management

• A majority (82%, or 67 out of 82) were managed non-operatively, suggesting many injuries could be treated conservatively.
• Nonetheless, a notable portion required major surgical interventions.

Outcomes and Complications

• Overall morbidity was 21%, indicating a substantial rate of complications among patients.
• Respiratory complications were most frequent (7 cases), which can often be serious in trauma patients.
• Median hospital stay was relatively short at two days, with a range up to 45 days, reflecting variable injury severity and recovery times.
• There were two deaths (2%) from severe traumatic brain injury caused by falls, underscoring the potential fatality risk of equestrian accidents.

Conclusions and Recommendations

• Horse-related injuries can be severe and result in significant medical intervention needs.
• Both riders and those around horses (non-riders) are at risk of injury.
• Use of appropriate safety equipment, like helmets and protective gear, and educational programs for riders and handlers are essential to reduce injury risk.
• Enhanced awareness and preventive measures could improve safety in equestrian activities in South Africa and similar settings.