Open fractures as a critical predictor of complications in animal-related orthopedic trauma: A six-year single-center cohort study

Animal attacks are an under-recognized source of orthopedic trauma with high morbidity and potential for severe complications. This single-center retrospective study describes the epidemiology, injury patterns, management, and outcomes of orthopedic injuries due to animal attacks over six years . We screened 280 patients presenting with animal-attack–related orthopedic injuries from January 2018 to January 2024; 182 were excluded for inadequate imaging, insufficient follow-up (<15 months), or incomplete records, leaving 98 patients for analysis. Collected variables included demographics, animal type, injury mechanism and distribution, treatments, complications, and mortality. Descriptive statistics were reported; Mann–Whitney U and Fisher’s exact tests were used for comparisons. Odds ratios (ORs) with 95% confidence intervals (CIs) identified risk factors for complications. Minimum follow-up was 15 months. Mean age was 39.8 ± 21.1 years; 78.6% were male. Equids accounted for 67.3% of injuries (horses 60.2%). Falls comprised the predominant mechanism (57.1%). Multiple anatomical regions were involved in 32.7% of cases. Surgery was performed in 91.6% of patients; open reduction and internal fixation was the most frequent procedure (31.6%). Overall complication rate was 13.3% (95% CI: 7.9%–21.4%); nonunion, infection, and wound problems were most common. Open fractures were strongly associated with complications (OR = 57.00; 95% CI: 2.75–1181.83; p = 0.0019), with all patients with open fractures experiencing at least one complication. Mortality was 3.1%. Animal-attack–related orthopedic injuries frequently require operative care and carry significant complication risk, particularly for open fractures. Early aggressive debridement, targeted wound management, and extended follow-up are essential.