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

Background: 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.

Aims: 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.

Methods: 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.

Results: 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.

Conclusion: 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.