Retrospective Study
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World J Clin Cases. Aug 16, 2014; 2(8): 345-350
Published online Aug 16, 2014. doi: 10.12998/wjcc.v2.i8.345
Tree stand falls: A persistent cause of neurological injury in hunting
Clifford A Pierre, Benjamin A Plog, Vasisht Srinivasan, Kaushik Srinivasan, Anthony L Petraglia, Jason H Huang
Clifford A Pierre, Benjamin A Plog, School of Medicine and Dentistry, University of Rochester, Rochester, NY 14623, United States
Vasisht Srinivasan, Jason H Huang, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY 14642, United States
Kaushik Srinivasan, School of Law, Case Western Reserve University, Cleveland, OH 44106, United States
Anthony L Petraglia, Department of Neurosurgery, Rochester Regional Health System, Rochester, NY 14626, United States
Author contributions: Pierre CA and Plog BA were responsible for the majority of the data collection; Pierre CA wrote the manuscript; Srinivasan V and Srinivasan K were responsible for manuscript editing, data analysis, and statistical work; Petraglia AL conceived and designed the study and was involved with manuscript editing and data analysis; Huang JH helped design the study and assisted with manuscript preparation.
Correspondence to: Anthony L Petraglia, MD, Department of Neurosurgery, Rochester Regional Health System, 2655 Ridgeway Avenue, Suite 340, Rochester, NY 14626, United States. apetraglia@unityhealth.org
Telephone: +1-585-2750060 Fax: +1-585-7565183
Received: March 24, 2014
Revised: May 11, 2014
Accepted: June 18, 2014
Published online: August 16, 2014
Processing time: 163 Days and 19 Hours
Abstract

AIM: To characterize and compare our current series of patients to prior reports in order to identify any changes in the incidence of neurological injury related to hunting accidents in Rochester, New York.

METHODS: All tree stand-related injuries referred to our regional trauma center from September 2003 through November 2011 were reviewed. Information was obtained from the hospital’s trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries.

RESULTS: Fifty-four patients were identified. Ninety-six percent of patients were male with a mean age of 47.9 years (range 15-69). The mean Injury Severity Score was 12.53 ± 1.17 (range 2-34). The average height of fall was 18.2 feet (range 4-40 feet). All patients fell to the ground with the exception of one who landed on rocks, and many hit the tree or branches on the way down. A reason for the fall was documented in only 13 patients, and included tree stand construction (3), loss of balance (3), falling asleep (3), structural failure (2), safety harness breakage (3) or light-headedness (1). The most common injuries were spinal fractures (54%), most commonly in the cervical spine (69%), followed by the thoracic (38%) and lumbar (21%) spine. Eight patients required operative repair. Head injuries occurred in 22%. Other systemic injuries include rib/clavicular fractures (47%), pelvic fractures (11%), solid organ injury (23%), and pneumothorax or hemothorax (19%). No patient deaths were reported. The average hospital length of stay was 6.56 ± 1.07 d. Most patients were discharged home without (72%) or with (11%) services and 17% required rehabilitation.

CONCLUSION: Falls from hunting tree stands are still common, with a high rate of neurological injury. Compared to a decade ago we have made no progress in preventing these neurological injuries, despite an increase in safety advances. Neurosurgeons must continue to advocate for increased safety awareness and participate in leadership roles to improve outcomes for hunters.

Keywords: Neurological sports medicine; Hunting; Tree stand falls; Spine injury; Traumatic brain injury

Core tip: Hunting is a popular sport and hunters have devised numerous ways to increase their advantage against their quarry. Tree stands have been developed to allow hunters better sight and increased protection. However, improper use, faulty construction, and other factors can increase the risk of injury, specifically to the central nervous system. We present the data obtained at our institution over an eight-year period cataloging the injuries obtained while using tree stands. We have begun outreach to the community with our findings, with the goal of increasing awareness and education to reduce risks and increase hunter safety.