Introduction: Deer hunting is popular in much of the United States. In Wisconsin, use of hunting tree-stands is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree-stands while hunting. This study's purpose is to systematically characterize and classify those injuries.
Methods: Our trauma center began classifying tree-stand falls as a unique cause of trauma in 1999. We reviewed the University of Wisconsin Hospital and Clinics’ trauma database for tree-stand-related injuries from 1999 to 2013. We collected data pertaining to hunters’ demographics, comorbidities, type and mechanism of injury, injury severity scores and Glasgow outcome scores.
Results: We identified 117 patients evaluated after a tree-stand fall. Of these, 65 patients (ages 16-76) suffered spine fractures, which occurred at all levels from occipital condyle to sacrum with thoracolumbar compression and burst fractures being most common. Fractures occurred in the following locations: craniocervical junction, 8 fractures; subaxial cervical spine, 19 fractures; thoracolumbar, 74 fractures. Twenty-five patients required surgical fixation. Nineteen patients experienced loss of neurologic function: 5 complete spinal cord injuries (SCI), 5 incomplete SCI, 2 central cord syndromes and 7 radiculopathies. Overall, patients fared well after their fall (mean GOS score: 4.64). However, the small subset of patients with neurologic compromise suffered significant morbidity, and in one case, mortality. Only four patients reported utilizing a safety harness.
Conclusions: Falls from hunting tree-stands represent a significant cause of spine and spinal cord injury in Wisconsin. Due to its retrospective nature, this review cannot provide information about risk factors for tree-stand falls. A prospective study has been designed for the upcoming hunting season to collect information about potential risk factors, aiming to construct a statewide intervention to decrease the rate of these injuries.
Patient Care: Our goal is injury prevention, with subsequent public health implications for cases involving significant morbidity and long term health care costs.
Learning Objectives: By conclusion of this session, participants should be well versed in the spine and spinal cord injuries associated with hunting from tree stands, as well as the necessity for tree stand safety precautions. Small group discussion could include potential intervention methods and effective modalities for encouraging hunters to adapt safety techniques.