Hand injuries more common during horse handling than riding

(c) Marina Sokalskaya Dreamstime.com

Horse-associated hand injuries occur more frequently during horse handling than riding according to a new study.

 The most common injuries in equestrian sports involve the head, followed by injuries to the upper extremities and the thoracic and lumbar spine. Among hand injuries, riding a horse ranks third as a cause after ball sports and cycling.

A study conducted in Northern Germany by Benedikt Ritter and colleagues at the Department of Plastic, Aesthetic, Hand, and Reconstructive Surgery at Hannover Medical School examined the circumstances, mechanisms, and locations of horse-related hand injuries, as well as the use of protective equipment. The work is published in the Archives of Orthopaedic and Trauma Surgery

This retrospective cohort study analysed records of patients admitted to the hand trauma centre. Complete records, including follow-up data, were available for 39 patients over a five-year period. The cohort included 35 females and 4 males, with ages ranging from 9 to 65 years. Only 7.7% of participants were professional riders, while 92.3% were amateur riders, some with equestrian training qualifications.

Data from clinical records and telephone interviews were analysed to investigate the mechanisms of trauma and injury patterns.

Key Findings:

• Over half of the injuries (21 cases) occurred while leading the horse, primarily due to traction forces exerted by bridles or lead ropes on the fingers.
• Falls accounted for 13 cases, and 5 cases resulted from bite injuries.
• The phalanges (fingers) were the most injured site (33 cases), followed by the metacarpal bones (hand) (4 cases) and the carpal bones (wrist) (2 cases).
• Fractures were present in over half (20) of cases.
• avulsion amputations occurred in nine (23.1%) of patients 
• Thirty one cases (79.5%) required surgical intervention.

The researchers note that, while horse-related injuries represent a small proportion of total emergency visits, they are disproportionately severe. They say that this emphasises the need for targeted preventive measures and specialised care to address the high rate of serious outcomes associated with these injuries.

They recommend wearing appropriate protective gloves to prevent hand injuries, as well as using self-opening panic hooks with overload protection to prevent excessive traction.

 

For more details, see: 

 

Ritter, B., Dastagir, N., Tamulevicius, M Bucher F, Obed D, Vogt PD, Dastagir K.

Equestrian-associated injuries of the hand: a retrospective analysis of injury mechanisms and patterns. 

Arch Orthop Trauma Surg (2024) 144, 4937–4945

https://doi.org/10.1007/s00402-024-05586-x

Horses Inside Out Conference

 There’s still time to get tickets for the Horses Inside Out Annual Conference. 

 Back this year at the Holywell Conference Center in Loughborough, it will be held on Saturday 18^th and Sunday 19^th February.  If you can’t be there in person, you can still attend virtually.

 

An array of expert speakers has been lined up for what promises to be an inspiring meeting. 

Topics to be covered include bitting, nutrition, training the equine brain, rider psychology, hindlimb lameness, hoof care, dental disease and more.

 

For all the details, go to: 

 

https://www.horsesinsideout.com/annual-conference-2023

Dangers of equestrian activities severely under-appreciated say US researchers.

  A recent study has found that the risk of an injury, requiring hospital admission, is higher for horse riding than for other potentially risky sporting activities, such as football, motor racing, or skiing.

Kevin Mutore and colleagues examined data supplied from level I and II trauma centers to the US National Trauma Data Bank (NTDB), on injuries sustained by adults while horse riding between 2007 and 2016. 

 

They retrieved details of 45,671 patients with equestrian injuries for this period. Data were incomplete for 20,880 patients, leaving 24,791 for inclusion in the analysis. The average age of those injured was 47, with almost equal proportions of men and women. 

 

Analysis showed that the most common site of injury was the chest, (37%) followed by arms and legs (26.5%). Head and neck injuries, although occurring less commonly (23%), were the most likely to prove fatal.

 

Severe neurological damage, classified as a Glasgow Coma Scale (GCS) score of 3–8, was observed in 888 (3.5%) patients. The GCS is a clinical scale used to measure a person's level of consciousness after a brain injury. It ranges from 3 (deep coma) to 15 (normal consciousness.) 

 

Riders with head and neck injuries were 44 times as likely to die as those with arm/leg injuries, while those with chest and abdominal injuries were around 6 times as likely to do so. 

 

The researchers point out that the study only included data from patients treated at US trauma centers that reported data to the NTDB. Nevertheless, the findings prompt them to conclude that: “Equestrian-related injuries are a frequently ignored public health issue.”

 

They go on to say: “When taken together, these data suggest that the dangers of equestrian activities have been severely underappreciated. When controlled for hours of activity, horseback riding resulted in a higher proportion of hospital admission than other higher risk activities like skiing.”

 

Protective gear can save lives, but is not always worn, they highlight. “Studies have shown that a large fraction of riders involved in equestrian injuries were not wearing helmets at the time of their accident. It stands to reason that raising awareness of the possible injuries and increasing preventive measures to protect against head injuries would significantly reduce mortality.”

 

They conclude: “We suggest that preventive measures and campaigns should be instituted to highlight safety practices. Implementing the consistent use of personal protective equipment, such as helmets and vests, will provide added protection to all riders (working or leisure) while on horseback. It is also imperative that medical professionals examine patients injured during horseback riding for head and neck injuries as these contribute to the highest mortality.”

 

Full details of the research are available in the open access paper published in the online journal Trauma Surgery & Acute Care Open.

See:

 

Mutore K, Lim J, Fofana D, Torres-Reveron A, Skubic JJ

Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA

Trauma Surgery & Acute Care Open 2021;vol 6: e000728. 

http://dx.doi.org/10.1136/tsaco-2021-000728

Identifying causes of girthing avoidance

Girthiness. The moment you start to tighten the girth, your normally placid and well-mannered horse

turns into a monster - biting, kicking, bucking….

It’s a frustrating and challenging problem to deal with. Saddle fit, back pain, gastric ulcers and innumerable other causes have been implicated.

A recent retrospective study looked at the clinical signs and final diagnosis of horses referred to a university clinic for girthiness.

Esther Millares-Ramirez and Sonia S Le Jeune went back through the records of horses examined at University of California, Davis between 2004 and 2012. During that time 37 horses had been referred for investigation of girthing problems.

The research has been published in the Journal of Equine Veterinary Science. 

The authors report that the final diagnosis was gastric ulceration in twelve horses, and orthopaedic problems in ten horses. Ill-fitting saddles were responsible for three cases. Other diagnoses included reproductive tract neoplasia, liver abscess and urinary tract infection.

Not all horses were subjected to gastroscopic examination, but of those that were, 92% had gastric ulcers.

The authors conclude that determining the cause of girthiness remains a challenge, but they recommend that as gastric ulcers were commonly involved, investigation should include gastroscopy.

For more details, see:

Girthiness: Retrospective Study of 37 Horses (2004-2016).

Millares-Ramirez EM, Le Jeune SS.

J Equine Vet Sci. (2019) 79:100-104.

doi: 10.1016/j.jevs.2019.05.025

Owners’ opinions of equine calming products

 Equine calming products (ECPs) are often used by owners to calm challenging or “unruly” horses, often with little scientific basis for their action and with little understanding of how, why or, indeed, whether they actually work.

Diane Ross of the North Highland College, University of Highlands and Islands, Scotland, and Jayne Roberts of Equijay, Brisbane, Australia, conducted a study to investigate owners’ attitudes to such products.

They distributed a survey to horse owners in the north of Scotland                                      .

How did respondents think ECPs work? Opinions varied. Over half (59%) of those replying thought magnesium was responsible for the calming effect; 9% thought it was due to herbs, valerian or tryptophan and 32% did not know which of the ingredients were responsible.

Were owners' satisfied that ECPs had the desired effect? A positive calming effect was reported by 48% of respondents; 30% were uncertain; 25% thought there was no effect; and 5% thought that rather than calming the horse they made their behaviour worse.

The authors conclude that horse owners appear willing to use ECPs without underpinning knowledge of ingredients or scientific evidence that they work.

For more details, see:

Equine Calming Products: A short survey into their use, effect, and knowledge using a small sample of horse owners in the north of Scotland, UK.

Ross DJ, Roberts JL.

J Equine Vet Sci. (2018) 68:63-67.

doi: 10.1016/j.jevs.2018.05.208