Knowledge
Medical Insight: Polodoc
Dr.med. Andreas Krüger is a Swiss board orthopaedic and trauma surgeon in Zurich, who specialises in knee and shoulder surgery. Andi is a second generation of tournament doctors for equine sports, known as Polodoc since 2013
Big Crack & No Air Combined Chest Injuries The chance of falling off your horse has two main categories – it is high for beginners learning to play polo and equally, for professionals who push the limits to take the extra risk to win. Despite injuries being rare, they are potentially very dangerous and can end with a player in the operating theatre. Although injuries of the chest wall, clavicle and scapula are much more frequent in motor vehicle, motorbike or cycling accidents, polo and other equestrian activities are also often associated with injuries of the chest.
Injury Mechanism
Three specific mechanisms can be identified: 1. Riding off or falling off the horse due to leaning out the middle and landing on the arm in adduction to the chest wall 2. Sudden stop or stumbling of the horse 3. Overrun by horse/opponent Especially when riders lean over in order to hit a ball with the mallet, they are putting themselves in an unstable position and may fall from the horse. Also, when riding off and getting in close contact with the opponent falls are possible or injury to the elbow or hitting arm. Not only can the impact from the fall itself cause serious injuries, but also when the rider gets overrun by his/her own horse or another rider.
The arrows indicate multiple and severely displaced rib fractures and laceration of the left lung
Injury Pattern
The most common injuries resulting from a fall are simple singular rib fractures, which per se do not require any special treatment
other than bandaging, pain killers and rest. On the other hand, rib fractures can occur in multiple locations, resulting in chest wall instability and difficulty in breathing.
‘Typical’ combination injury, pictured all in the same patient
Rib fractures on the right, associated with midshaft fracture of the clavicle
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Polo Times, May 2020
Serial rib fractures with pneumothorax, lung laceration – here the lung was trapped in the rib fracture and needed to be freed up
Treatment consisted of surgical fixation of the clavicle, minimally invasive lung repair and fixation of the adjacent rib fractures
www.polotimes.co.uk
