• Scott S Short, Stephen J Fenton, Eric R Scaife, and Brian T Bucher.
• Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States. Electronic address: Scott.Short@imail2.org.
• J. Pediatr. Surg. 2018 Mar 1; 53 (3): 545-547.

PurposeAwareness of equestrian related injury remains limited. Studies evaluating children after equestrian injury report under-utilization of safety equipment and rates of operative intervention as high as 33%.MethodsWe hypothesized that helmets are underutilized during equestrian activity and lack of use is associated with increased traumatic brain injury. We queried the trauma database of a level one pediatric trauma center for all cases of equestrian and rodeo related injury from 2005 to 2015. Analysis was conducted using SAS 9.4.ResultsOf 312 children identified, 142 were assessed for use of a helmet. Only 28 children (19.7%) had documented use of a helmet. Most injuries occurred while riding a horse (83%) or bull (13%) with traumatic brain injury being the most common injury (51%). Helmet use was associated with decreased ISS (7.1 vs. 11.3, p<0.01), TBI (32.4% vs. 55.3%, p=0.03), and ICU admission (10.7% vs. 29%, p=0.05). Multivariable analysis reveals lack of helmet use to be an independent predictor of TBI (OR 2.5, 95% CI 1.1-6.3).ConclusionHelmets are underutilized by children during equestrian related activity. Increased awareness of TBI and education encouraging helmet use may decrease morbidity associated with equestrian activities.Level Of EvidenceRetrospective comparative study, Level III.Copyright © 2017 Elsevier Inc. All rights reserved.

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