Equestrian-related maxillofacial injuries-a five-year retrospective review

Equestrian-related activities inherently involve the risk of serious injury. There are few reports of maxillofacial injury patterns and management arising from equestrian activities in the literature.

To investigate maxillofacial fracture presentations at a tertiary trauma centre to identify injury profiles of patients who have sustained equine-based injuries over 5 years.

This work involved a retrospective review of all trauma presentations to our unit over 5 years. The data collected included patient demographics, injury mechanisms and patterns, and management of fractures.

The study identified 73 patients with facial fractures resulting from activity with horses between 2020 and 2025. A total of facial fractures were recorded. The mean age was 39.5 (11-86) years. There were 40 (55%) males and 33 (45%) females. Mounted riders accounted for 41% of cases, with 59% being unmounted. The incidence of head injury was 5%. A further 5% had an associated spinal injury. The most common specific mechanism of maxillofacial injury was a direct kick, in 55% of cases. The most commonly affected facial region was the middle third (81%), with zygomaticomaxillary complex fractures most commonly recorded (39%). There was a statistically significant increase in the risk of head injury associated with frontal bone fracture in this group.

Activities involving horses pose a high risk of maxillofacial injury. Education should be promoted to increase the usage of helmets with a particular design to protect the facial skeleton, whether mounted or unmounted.