Abstract: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. This article presents four cases of equestrian injury treated in Gunma University Hospital: Case 1: hepatic injury (fall and kick by the horse); Case 2: left hemopneumothorax and pulmonary contusion with multiple rib fractures (fall and trampling by the horse); Case 3: lumbar compression fracture (fall); and Case 4: scrotum injury (horse bite). Equestrian injuries may… Show more
“…Horse riding is a worldwide widespread professional, recreational and sport activity which is associated with a significant risk of accidents and injuries of the musculoskeletal system [3,4,10]. Spine and spinal cord injuries are not uncommon during horse riding and equestrian activities whether for professional or other athletic or recreational purposes [1,[10][11][12][13][14][15][16][17][18][19][20]. According to Boran et al [10] equestrian activities over a period of 10 years in Ireland was the most common cause of spine injuries at a rate of 41,8%.…”
Horse-related athletic, recreational and professional activities is a worldwide widespread practice involving people of all ages. This kind of activity, due to the particular risks involved, is associated with a significant number of accidents and injuries of the musculoskeletal system. Spine injuries (SI) and spinal cord injuries (SCI) are serious injuries that can have devastating consequences for the rider. In the present review, we examined their epidemiology, their characteristics in terms of the mechanism and type of injury, the neurological damage they cause and the injured region of the spine. The type of the therapeutic approach and its results were also analyzed. 19 papers that included 7.569 patients, 632 (8.3%) of whom suffered spine or spinal cord injuries, were analyzed. A total of 1.072 injuries were analyzed, 56 % of which concerned men and 44% women. The fall from a horse is considered to be the main mechanism that causes injuries associated with fractures of the thoracic and lumbar spine. 58% of the patients with such injuries were hospitalized. There was a complete neurological damage in 31.8% of the patients, while in a significant proportion of 53.5% of the patients; quadriplegia was caused by the injury. Although conservative treatment in simple cases without neurological damage appears to be an effective therapeutic approach, in cases of unstable injuries and neurological impairment surgical treatment can be a method of choice with satisfactory results such as better mobilization and quality of life.
“…Horse riding is a worldwide widespread professional, recreational and sport activity which is associated with a significant risk of accidents and injuries of the musculoskeletal system [3,4,10]. Spine and spinal cord injuries are not uncommon during horse riding and equestrian activities whether for professional or other athletic or recreational purposes [1,[10][11][12][13][14][15][16][17][18][19][20]. According to Boran et al [10] equestrian activities over a period of 10 years in Ireland was the most common cause of spine injuries at a rate of 41,8%.…”
Horse-related athletic, recreational and professional activities is a worldwide widespread practice involving people of all ages. This kind of activity, due to the particular risks involved, is associated with a significant number of accidents and injuries of the musculoskeletal system. Spine injuries (SI) and spinal cord injuries (SCI) are serious injuries that can have devastating consequences for the rider. In the present review, we examined their epidemiology, their characteristics in terms of the mechanism and type of injury, the neurological damage they cause and the injured region of the spine. The type of the therapeutic approach and its results were also analyzed. 19 papers that included 7.569 patients, 632 (8.3%) of whom suffered spine or spinal cord injuries, were analyzed. A total of 1.072 injuries were analyzed, 56 % of which concerned men and 44% women. The fall from a horse is considered to be the main mechanism that causes injuries associated with fractures of the thoracic and lumbar spine. 58% of the patients with such injuries were hospitalized. There was a complete neurological damage in 31.8% of the patients, while in a significant proportion of 53.5% of the patients; quadriplegia was caused by the injury. Although conservative treatment in simple cases without neurological damage appears to be an effective therapeutic approach, in cases of unstable injuries and neurological impairment surgical treatment can be a method of choice with satisfactory results such as better mobilization and quality of life.
“…2B). Table 2 [6,12,13,14,15,16,17,19,20,21,22,24,32,33,34,38,39,40,41,42,43,44,45,46,47,48] lists cases that required surgical intervention outlining the details of mammalian bite and operative plans.…”
Section: Cohort Characteristics Of Genital Injurymentioning
Objective
To review existing publications to determine the approaches for the medical and operative management of mammalian bites to the external genitalia.
Materials and Methods
The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis for Scoping Review guidelines were followed. Four databases were searched. Articles were independently screened and analysed by two reviewers. Publications were included if detailed summaries of genitalia bites and management were documented. Discrepancies were resolved by a third reviewer. Data were extracted from the final article cohort.
Results
A total of 42 articles were included in this scoping review with 67 cases of mammalian bites to the genitalia reported in the cohort. The most common injury site was the penis (44.9%). Dog and human bites were the most common type of mammalian bites (61.2% and 26.9%, respectively). In all, 13.4% of cases were managed with medical therapy while 86.6% of cases required surgical intervention. The most common intervention was wound irrigation, debridement, and primary closure (32.8%). Although uncommon, other operative approaches included skin flaps (7.5%) and grafts (4.5%), re‐implantation (4.5%), urethroplasty/repair (7.5%), penectomy (3.0%), scrotoplasty (3.0%), and perineal urethrostomy (1.5%). The reported complication rate was 19.4%. The mean follow‐up time was 39.9 months.
Conclusion
Trauma related to mammalian bites is associated with high utilisation of healthcare resources and cost. Although management of such bites to the genitalia is controversial, surgical intervention is often warranted ranging from simple debridement of devitalised tissue to complex reconstructive surgery. This review underscores the need for further investigation of mammalian bites to the genitalia to improve surgical options and monitor for long‐term complication rates.
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