Major pelvic injuries in equestrian sports

Abstract

A series of pelvic and acetabular injuries caused by horse riding accidents is reported. The importance ofwearing appropriate protective clothing when riding is emphasised. (BrJ_ Sports Med 1997;31:249-251) Keywords: horse riding; pelvis; acetabulum Horse riding accidents at both amateur and professional levels are associated with a wide variety of injuries. While most equestrian related injuries are of moderate severity, these accidents can also result in major lifethreatening fractures. This paper reports a series of pelvic and acetabular injuries caused by horse riding accidents and referred to this unit, which is a national referral centre for treatment of pelvic and acetabular fractures.Patients and methods Two hundred and five patients with pelvic and acetabular fractures were treated by operation at our unit between 1987 and 1995. Most of the injuries were caused by motor vehicle accidents or falls from a height. Nine patients sustained their injury while engaged in horse riding or horse racing activities over the past four years. All patients, except one who had died from a cause unrelated to his injury, responded to a questionnaire relating to their level of riding experience, the level of training of their horse, the circumstances of the accident, and the nature of protective riding equipment worn.fixation of the sacroiliac joint and pubic symphysis (fig 3) was then performed at 7-10 days. Two patients had fractures of the ilium without disruption of the pelvic ring, and two patients had fractures of the acetabulum, one of the posterior acetabular wall, and one of the anterior column, all of which were managed surgically with open reduction and internal fixation of the fracture within one week of the accident.The mean follow up time since pelvic surgery was 17 (range 1-40) months. The mean hospital stay was 24 (range 11-45) days. One patient was injured by an untrained horse which knocked her down in a stableyard; the remaining eight horses, all of which were mounted at the time of the accident, had been fully schooled. Two of the accidents occurred during a hunt and in both cases the riders were trained and experienced in hunting. All riders were familiar with the horse from which they fell. All riders wore a helmet with a retaining strap when they fell and none of the helmets was damaged by the fall. No riders wore body protectors which are currently recommended for horse riding.' None of the riders had consumed alcohol before their accident. Five patients have ridden horses since the accident while four feel they will not be able to ResultsOf a total of 205 pelvic and acetabular fractures requiring major pelvic internal fixation, nine injuries were sustained as the result of horse riding accidents. The mean age of the riders was 46 (range 18-75) years. Seven were men and two were women. Eight of the patients were very experienced amateur riders, with a mean riding experience of 30 (range 10-50) years, and one was a professional jockey. Six of the riders had previously been involved in ...

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