Helmet use and head injury in severe equestrian trauma
The aim of the study was to examine helmet use, incidence of injury, and patient outcomes in a rural cohort of equestrian accidents.
Despite being viewed as a relatively safe pastime, equestrian activities are among the most accident-prone, sustaining more injuries per hour than American football, motorcycling, skiing and car racing.
Helmets are believed to reduce head injury frequency and severity. Helmets disperse the energy of an impact to the head. The previous work supports helmets as a means to reduce the likelihood of skull fractures. However, there is still discussion surrounding their ability to prevent intracranial injuries.
Helmets are not well liked among ranchers and rodeo riders in the West. Helmets are uncomfortable, reduce visibility, impair hearing, do not offer the sun or rain protection of a traditional cowboy hat, or are simply unconventional. Regulations mandating helmets generally only apply to youth or are optional for adults. Absent from these guidelines is recommendations for helmet type and quality. As a result, many helmets used in rodeo are adapted from other sports such as hockey and use remains low in Western riding and it is unknown whether they improve health-care outcomes.
This retrospective analysis examined patients with equine related injuries who presented at a Level II Trauma center in the Northwest U.S. between 2011 and 2020. The sample was identified using the trauma registry.
EHR records of patients admitted to a Level II ACS trauma center were reviewed for helmet use. Injuries were categorized according to International Classification of Diseases-9/10 code.
Fifty-two cases were identified. The sample was predominantly female (n = 33) and White (n = 48). Both groups were comparable in terms of age, gender and body mass index, where their injury occurred, experience, and riding activity. Of those not wearing a helmet, most were riding as part of their work (43%) or recreation (33%). Most wearing helmets were riding for recreation (69%). When viewing those riding for work, only two (13%) wore a helmet.
Of the identified cases, helmets only reduced superficial injury (χ2 (1) = 4.837, P = 0.028). Intracranial injury rates were not different between those with and without helmets (P > 0.05).
In conclusion, in equine related injury, helmets protect against superficial injury but not intracranial injury in Western riders.
Researchers said that this does not mean that helmets do not provide protection to the user and do not change the outcome of equine-related accidents. The research also highlights the importance of developing better helmet technology and educating riders, so they choose to utilize and maintain proper safety equipment.
Carter BT, Richardson MD. "A retrospective study of helmet use and head injury in severe equestrian trauma." J Neurosci Rural Pract 2023;14:161-4. doi: 10.25259/JNRP-2022-3-14
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