The Surgical Burden of Animal Bites Referred to Orthopaedics: A 10-Year Cohort Study of 168 Patients From a UK Major Trauma Centre

Introduction Animal bites impose a substantial, yet under-recognised, burden on orthopaedic services. We characterised the epidemiology, injury patterns, management, and short-term outcomes of bite injuries requiring orthopaedic input at a UK Major Trauma Centre over 10 years. Methods We performed a retrospective cohort study of consecutive patients referred to orthopaedics with animal-bite injuries between December 2015 and March 2025. Eligible cases were identified from a prospectively maintained trauma database and verified against electronic records. Inclusion encompassed mammalian, reptile, avian, fish, amphibian, and spider bites; human, "fight," and insect stings/tick exposures were excluded. Demographics, injury site and structures involved, management (operative vs non-operative), microbiology, complications, readmissions, and length of stay (LOS) were extracted using a standardised proforma. Early presentation was defined as <24 hours post-injury. Descriptive statistics were used. Results We included 168 patients. A total of 158 (94.0%) were adults; 89 (53.0%) were females; and the mean age was 49 years. Early presentation occurred in 88 (52.4%); LOS 2.6 vs 2.9 days for delayed. Domestic animals accounted for 166 (98.8%) injuries, dogs (110, 65.5%) and cats (56, 33.3%). Upper limb involvement predominated, 160 (95.2%); hand injuries were most common, 128 (76.2%). Structural damage included 11 (6.5%) open fractures, 15 (8.9%) tendon, 14 (8.3%) muscle, seven (4.2%) nerve, and two (1.2%) vascular injuries. Dog bites accounted for all open fractures and all neurovascular injuries, and most tendon (11, 73.3%) and muscle (11, 78.6%) trauma; multi-limb injuries were dog-related in 16 (88.9%). Overall, 109 (64.9%) underwent surgery and 12 (7.1%) required reoperation. Microbiology was obtained in 82 (48.8%); 41 (50.0%) were culture-negative. <i>Pasteurella</i> spp. predominated, <i>Pasteurella canis</i> in dog bites and <i>Pasteurella multocida</i> in cat bites, frequently associated with debridement. Readmissions were more common after delayed presentation (5 vs 2), including one digit amputation. Conclusions Over a decade, animal bites referred to orthopaedics were chiefly domestic, concentrated in the hand, and often required surgery, particularly dog-bite injuries with complex structural damage. Early presentation shortened LOS but did not avert operative need; delayed presentation carried higher infectious morbidity. Findings support prompt assessment, species-informed empirical antibiotics, and streamlined orthoplastic pathways, alongside public-health measures promoting early care-seeking and responsible ownership.