HORSE RIDING ACCIDENTS INVOLVING CHILDREN

In a retrospective study we reviewed 262 horse riding related injuries in children younger than 16 which were treated between 1975 and 1989 at the Section of Traumatology in the Department of Surgery, Universit y Hospital Homburg/Saar. In 155 of these accidents, detailed informati on was gained via a questionnaire. The typical patient profile was tha t of young female equestrians with little experience and litte weekly riding practice, without practicing falling-exercises and warming up o ften using different horses. At the time of the accident only 59 % wer e wearing a head protection. Most accidents happened in the summer mon ths in the afternoon during leisure riding on a large familiar horse i n the riding hall. Apart from the typical accidents like falling of th e horse (64.9 %) and falling with the horse (5.7 %) accidents in handl ing the horse were of special significance: Kick by horse's hoof (11.8 %), being stepped by horse (3.8 %), horsebite (7.3 %) and injuries of horse's bridle had their own pattern of injuries. Injuries of the dis tal parts of the upper extremity are preeminent in falling of the hors e, whilst in falling with the horse head injuries and shoulder injurie s are preeminent. Remarkably often injuries of kick by horse's hoof we re causing sometimes even dangerous head injuries (41.6 %). Overall in horse riding related injuries in childhood superficial soft tissue in juries (48.6 %) and fractures (30.6 %) were predominant. Fractures of the clavicle which are well known as a riding injury proved to be typi cal for a fall with the horse, whilst a fractured vertebra was only se en once amongst the 262 children treated. The severity of the injuries was lower than expected: In 85.1 % of all the injuries only one body region was injured, 90.1 % could be assigned to an injury severity sco re (ISS) of 1-3. Ponyriders had less severe injuries than riders of la rge horses. One fatal accident happened in handling a horse, in these situations preventive measures are often disregarded. Active (better e ducation, warming up, falling practice) an passive (head protection!) safety measurements are recommended for prevention of injuries in youn g riders in particular.