Joint dislocations due to equestrian activity: what can a sports physician anticipate?

Horse riding is a common sport, but no study specifically addresses joint dislocations. The purpose of this study is to describe joint dislocations due to equines using a national emergency department (ED) database. Such data can be helpful in injury prevention strategies.

The National Electronic Injury Surveillance System (NEISS) database for the years 2000-2023 was used. The NEISS database is a statistically representative sample of injuries seen in EDs across the US giving national estimates. Mechanism of injury was tabulated into groups: 1) did the patient fall from the horse 2) was the patient bucked, thrown, or kicked off of the horse, 3) was there equipment (tack) malfunction, 4) was the patient stepped on by the horse, 5) was the patient struck by/against an object, 6) was the patient kicked by the, 7) and others.

There were 625 dislocations which involved the shoulder (289, 46.2%), elbow (95, 15.2%), finger (85, 13.6%), acromioclavicular joint (48, 7.7%), patellofemoral joint (39, 4.8%), hip (22, 3.5%), pubic symphysis (16, 2.6%), and ankle (7, 1.1%). The average age was 41 years; 49.7% were male and 50.3% female. Mechanisms of injury were falling from the horse (54.1%), bucked/thrown off (27.7%), equipment malfunction (7.3%), stepped on by the horse (2.1%), struck by/against an object (1.9%), kicked (0.6%), and others (4.0%). Those with elbow dislocations were the youngest (average 32 years) and pubic symphysis the oldest (average 52 years) (p < 10^-4). Females had the highest percentage of patellofemoral dislocations (70.2%) and males the highest percentage of pubic symphysis dislocations (92.9%) (p = 0.0018).

Although joint dislocations due to equestrian activity are uncommon, the majority occurred in the upper extremity. Male/female involvement is equal, different than the typical female predominance in equestrian activity and overall equestrian related injuries.