{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:31:47Z","timestamp":1786361507066,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Objectives: To systematically review the evidence on horse-related maxillofacial trauma, with emphasis on horse-kick injuries, anatomical patterns, associated injuries, management, outcomes, and prevention. Methods: This systematic review followed the PRISMA 2020 statement. PubMed\/MEDLINE, Scopus, Web of Science, and the Cochrane Library were searched for original clinical studies reporting facial, craniofacial, orbital, dental, or maxillofacial injuries related to horse-associated activities. Data were extracted on study characteristics, demographics, mechanism, mounted\/unmounted status, anatomical site, associated injuries, treatment, complications, outcomes, mortality, and protective equipment. Due to substantial heterogeneity in study design, denominators, and outcome reporting, a structured narrative synthesis was performed without formal meta-analysis. Results: Twenty-eight original clinical studies were included. Maxillofacial-specific series consistently identified horse kicks as a major mechanism, especially among unmounted individuals. Injuries most frequently involved the midface, orbit, zygomaticomaxillary complex, mandible, nasal region, and dentoalveolar structures. Severe presentations included optic nerve avulsion, orbitocranial penetrating trauma, naso-orbito-ethmoid and frontal sinus fractures, airway compromise, intracranial injury, and multisystem trauma. Management ranged from conservative treatment to operative fixation, orbital reconstruction, soft tissue repair, advanced airway management, and multidisciplinary care. Helmet use was often absent or poorly documented, particularly during unmounted activities. Conclusions: Horse kicks represent a distinct localized high-energy mechanism of maxillofacial trauma. Prevention should extend beyond riding and include facial protection, protective eyewear, and safety protocols for ground-based horse handling.<\/jats:p>","DOI":"10.3390\/jcm15166189","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:23:50Z","timestamp":1786357430000},"page":"6189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of a Horse Kick: A Systematic Review of Horse-Related Maxillofacial Trauma"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7789-145X","authenticated-orcid":false,"given":"Luigi Angelo","family":"Vaira","sequence":"first","affiliation":[{"name":"Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareem","family":"Qadeer","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"},{"name":"PhD School of Biomedical Sciences, Department of Biomedical Science, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8070-9517","authenticated-orcid":false,"given":"Sebastiano","family":"Stellino","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"Jerome R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium"},{"name":"Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, 86000 Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1251-0185","authenticated-orcid":false,"given":"Antonino","family":"Maniaci","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1080-4067","authenticated-orcid":false,"given":"Fabio","family":"Maglitto","sequence":"additional","affiliation":[{"name":"Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-5847","authenticated-orcid":false,"given":"Giuseppe","family":"Consorti","sequence":"additional","affiliation":[{"name":"Division of Maxillofacial Surgery, Department of Neurological Sciences, Marche University Hospitals\u2014Umberto I, 60100 Ancona, Italy"},{"name":"Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6830-9309","authenticated-orcid":false,"given":"Giulio","family":"Cirignaco","sequence":"additional","affiliation":[{"name":"Division of Maxillofacial Surgery, Department of Neurological Sciences, Marche University Hospitals\u2014Umberto I, 60100 Ancona, Italy"},{"name":"Department of Medicine, Section of Maxillo-Facial Surgery, University of Siena, Viale Bracci, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6889-1012","authenticated-orcid":false,"given":"\u0141ukasz","family":"Wo\u017aniak","sequence":"additional","affiliation":[{"name":"Department of Dental Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9869-9240","authenticated-orcid":false,"given":"Carlos","family":"Navarro-Cu\u00e9llar","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Department, Hospital Gregorio Mara\u00f1on, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u017cena","family":"Antonowicz","sequence":"additional","affiliation":[{"name":"Department of Dental Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Borys","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial and Plastic Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3947-8733","authenticated-orcid":false,"given":"Giovanni","family":"Salzano","sequence":"additional","affiliation":[{"name":"Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7201-6445","authenticated-orcid":false,"given":"Giacomo","family":"De Riu","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.injury.2014.03.016","article-title":"On and off the horse: Mechanisms and patterns of injury in mounted and unmounted equestrians","volume":"45","author":"Carmichael","year":"2014","journal-title":"Injury"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1007\/s00264-017-3592-1","article-title":"Blunt injuries related to equestrian sports: Results from an international prospective trauma database analysis","volume":"41","author":"Weber","year":"2017","journal-title":"Int. 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