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  • Tree Stand Falls: A Persistent Cause of Neurological Injury in Hunting

    Final Number:

    Anthony L. Petraglia MD; Vasisht Srinivasan MD; Benjamin Plog; Clifford Pierre; Jason H. Huang MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: Tree stand falls are a well-known cause of hunting-related injury. Spine and brain injuries associated with such falls can result in significant neurological morbidity. We sought to characterize our current series of patients and compare to prior reports in order to identify any changes in the incidence of neurological injury related to such hunting accidents.

    Methods: From September 2003 to November 2011, all tree stand-related injuries referred to our regional trauma center were reviewed. Information had been recorded in the hospital's trauma registry, and medical records were retrospectively reviewed for data pertaining to the injuries, with particular emphasis on neurological injuries and any associated details.

    Results: A total of 54 patients were identified. Ninety-six percent of patients were male. Mean age 47.9 yrs(range 15-69). The mean Injury Severity Score was 12.53+/-1.17 (range 2-34). Average height of fall was 18.2 feet(range 4-40 feet). All patients fell to the ground with exception of one patient falling onto rocks; and many hit the tree or branches on the way down. A reason for fall was documented in only 13 patients, and included tree stand construction(3patients), loss of balance(3patients), falling asleep(3patients), structural failure(2patients), safety harness breaking(3patients) or light-headedness(1patient). The most common injuries were spinal fractures(54% patients). In these patients, fractures to the cervical spine were the most common(69%), followed by the thoracic(38%) and lumbar(21%) spine. Eight patients went to the operating room for fusion. Head injuries occured in 22% of patients. Average LOS was 6.56+/-1.07 days. Disposition was home(72%), home with services(11%), and rehab placement(17%). Details regarding other systemic injuries will also be reviewed.

    Conclusions: Falls from hunting tree stands are still common, with a high rate of neurological injury. Compared to a decade ago we have made no progress in preventing these neurological injuries, despite safety advances - which is unacceptable.

    Patient Care: This review will raise awareness about the spectrum of neurological injury encountered in hunting tree stand falls. We need to do a better job at advocating for neurological injury prevention in hunting, as this review has shown that we have made no progress in preventing such injuries in over a decade. This review will hopefully inspire some neurosurgeons to get involved with educating hunters on the risks of tree stand use, the avoidance of common errors, and ways to maximize their safety and enjoyment. Additionally, reviews such as this will continue to remind others the role neurosurgeons may play in neurological sports medicine.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the sprectrum of neurological injuries encountered in hunting tree stand-related falls, 2) Discuss, in small groups, key causes of falls, 3) Identify potential ways for neurosurgeons to advocate for hunter safety through regional and community-wide injury prevention programs


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