Horse kick injury mimicking a handle bar injury or a hidden speared injury

Abstract

A 16-year-old male was transported to our emergency department after he was kicked in the abdomen by a horse. He was diagnosed with injury of the liver and abdominal rectus muscle, and was cured by observational treatment. An Ichushi search was undertaken to identify articles published from 1983 to 2013 using the key words "horse" and "trauma". We found 13 cases that described horse-related injuries and summarized these cases, including our case. There were 10 males, three females and one patient of an undescribed sex. The patients ranged in age from 16 to 58 years old, with an average age of 33 years. The injured sites were predominantly the face (mandible) and upper abdomen, indicating that a projecting part of the body may be more likely to be injured. Cardiac rupture, aortic head injury, or lethality induced by a horse kick have not been reported in Japan, but such injuries have been reported in other countries. Ten of 15 cases (67%) required surgical treatment for severe injuries. Horse kick injuries tend to be severe, because the transfer of energy from the end of the hoof, with a small cross-sectional area, to a small field, leads to internal organic injuries that are more severe than predicted, similar to a handlebar injury. Accordingly, we advocate the close observation of patients with horse kick injuries, which may be regarded as being similar to blunt stab wounds or hidden speared injuries.

Persistent Intracranial Hypertension in a Cranial Vault Remodeling Patient With Open Skull Fractures From Horse Kick

“…Horse kick injuries involve a high force propagated over a small cross-sectional area, resulting in high-pressure injuries. Damage can include ventricular rupture, severe abdominal organ injury, long bone fractures, craniofacial factures, and intracranial hemorrhage (Cherniawsky et al, 2014; Oode et al, 2016). Fatalities from horse kick have been reported, most commonly resulting from head trauma (Kiuru et al, 2002; Jagodzinski and DeMuri, 2005; Ebert et al, 2012; Carmichael et al, 2014).…”

Characteristics of patients who fell into open drains: a report from a single emergency center in East Shizuoka

“…Our hypothesis for this severity is as follows: when a human falls into an open drain, the concrete corner of the drain hits a part of his or her body. The transfer of energy from the end of the concrete corner, with a small cross‐sectional area, to a small field on the body may lead to more severe injuries of the internal organs than one might predict, similar to a handlebar or horse kick injury . We will prospectively collect data concerning ditch‐related injuries (Investigation of etiology of injuries induced by open ditch, UMIN000017535) and we will check the body surface of ditch‐related injuries to test whether our hypothesis is correct.…”

Report of Four Cases with Equestrian Injury: Therapeutic Approach and Outcome

“…Equestrianism is associated with a risk of severe trauma due to falls and/or direct injury from the horse, depending on the mechanism of injury. However, horse riding is not a common sport in Asian countries such as Hong Kong [ 1 ] and Japan [ 2 ]; therefore, equestrian injuries are rare in this region. This article presents four cases of equestrian injury treated in Gunma University Hospital in Japan.…”