Introduction: Injuries to the nervous system are an inevitable part of many sports. We describe our series of eighty patients with injuries sustained during participation in equestrian sports.
Methods: From October 2003 to November 2011, all equestrian injuries referred to our regional trauma center were reviewed. Data had been recorded in the hospital's trauma registry and medical records were reviewed retrospectively for additional data pertaining to those injuries with specific emphasis on neurological injuries and associated details.
Results: Eighty patients were identified. Fifty-four percent of riders were female. The average age was 37 years (range 2.2 - 79.3 years) and 93% arrived to the hospital with a GCS of 15. The average Injury Severity Score was 9.9 ± .7. Only two patients had documented helmet use and two patients had documented alcohol use. The mechanisms of injury varied; Fifty-five percent were kicked or stepped on, 28% were thrown or fell off, and 21% sustained injuries from the horse falling on them. The causes of injuries ranged from carelessness and lack of attention to animal factors including inadequate training of horses and animal fear.
The most common injuries were head injuries (28% of patients), which included concussions, intracranial hematomas/hemorrhages, and skull/facial fractures. Spine fractures were identified in 10% of patients, with the majority (63%) being transverse process fractures.
Fourteen percent required operative interventions for their injuries. There were no mortalities and the average length of stay was 3.7 ± .35 days. All patients were discharged home with 95% requiring no assistance or services.
Conclusions: Equestrian sports conveys its own special risks for its participants. With proper protection and precautions, a decrease in the incidence of central nervous system injuries may be achieved. Neurosurgeons can play key roles in advocating for neurologic safety in equestrian sports.
Patient Care: This review brings to light the importance of proper protection, including a helmet and other protective gear, when participating in sports with a risk of neurological injury. It will raise awareness in the neurosurgical community about these injuries and the role neurosurgeons may play as advocates for participant safety.
Learning Objectives: By the conclusion of this session, participants should be able to:
1) Describe the spectrum of neurological injury sustained by participants of equestrian sports
2) Discuss, in small groups, the means by which these injuries may be avoided or reduced
3) Identify root causes of injuries to develop strategies for prevention