[Cirurgia Taurina--emergency medical treatment of bullfighters in Spain]

Eight-year analysis of bullfighting injuries in Spain, Portugal and southern France

Improving knowledge on the epidemiology and analysing the prognostic factors of severity for injuries caused by fighting bulls in Spain, Portugal and southern France. Observational retrospective study including 1239 patients with a reported history of bull horn injuries between January 2012 and November 2019 in Spain, Portugal or southern France. A multiple logistic regression test was used to analyse the prognostic factors of severity and mortality rate of these lesions. The mean accident rate was 9.13% and the mortality rate was 0.48%. The most frequent mechanism of trauma was goring, and the commonest locations of the lesions were thigh and groin. Vascular lesion was found in 20% of thigh/groin gorings. Prognostic factors of severity were vascular lesion, head trauma, fracture, goring injuries and age of the animal. The most reliable prognostic factors of mortality were vascular lesion and goring in the back. Lesions caused by fighting bulls are common in the bullfighting events held in Spain, Portugal and southern France. Although the mortality rate is low, there is a higher morbidity rate, which is conditioned by vascular lesion. All medical teams should include a surgeon experienced in vascular surgery and an anaesthesiologist.

Taurine surgery in the 21st century from glory to contempt

Bullfighting surgery has gone from being something that the surgeon could be proud of in any setting to being an activity frowned upon from a social point of view, and even in our surgical guild. However, popular bullfighting festivities are still very frequent, with thousands of injured each year, some of them serious. Currently, health care in bullfighting festivals is immersed in a complex problem mainly due to four factors: 1) social and professional discredit; 2) poorly paid professional activity; 3) neglect by professional and academic institutions; and 4) lack of a specific body of doctrine. All this has led to the health care teams in bullfighting surgery being less and less professionalized and more inexperienced, to problems of professional intrusion. Consequently, there is a direct impact on the quality of care provided and on the morbidity and mortality rates of injured participants, with the legal implications that this entails. A restructuring of this situation and the support of professional institutions, especially Medical Associations, and academic institutions, is necessary.

Taurine surgery in the 21st century from glory to contempt

Bullfighting surgery has gone from being something that the surgeon presumed in all areas of his environment to being an activity frowned upon from a social point of view and included in our surgical guild. However, popular bullfighting festivities are still very frequent, with thousands of injured each year, some of them serious. Currently, health care in bullfighting festivals is immersed in a complex problem mainly due to four aspects: 1) social and professional discredit, 2) poorly paid professional activity, 3) abandonment by professional and academic institutions, and 4) lack of a specific body of doctrine. All this is leading to the health care teams in bullfighting surgery being less and less professionalized and more inexperienced, to problems of professional intrusion, and consequently is having a direct impact on the quality of care provided and on the morbidity and mortality of the injured population, with the legal implications that it entails. A restructuring of this situation and the support of professional institutions, especially Medical Associations, and academic institutions, is necessary.

Bullhorn and bullfighting injuries

PURPOSE

Our purpose was to present our hospital experience with bullhorn injuries.

METHODS

A retrospective analysis of patients in our Trauma Registry (1993-2012).

RESULTS

Fifteen patients were included. All were hemodynamically stable on presentation, with a mean Glasgow Coma Scale (GCS) score and a Revised Trauma Score (RTS) of 15 and 11.9, respectively. The Injury Severity Score (ISS) and New Injury Severity Score were 13.6 ± 6 and 15.9 ± 9, respectively. Seven had an ISS > 15. Injuries resulted from an isolated blunt trauma (BT) in four, penetrating trauma (PT) in seven, with extensive soft tissue injuries (STI) in three, and a combined BT + PT mechanism in four patients, with extensive STI in all. Three patients had injuries to vessels in the groin, two with prehospital vein ligation. Five patients had abdominal visceral injuries, and another had a sheathed goring, with a traumatic abdominal wall hernia and retroperitoneal hematoma. Four patients had thoracic injuries, and one of them had a traumatic thoracoplasty with a large open thoracic wound, a flail chest, and extensive STI. Two patients had traumatic brain injury, and six had bone fractures. Two-thirds of patients required a surgical procedure under general anesthesia. Morbidity included three surgical site infections, one leg compartment syndrome, and one persistent lymph drainage. There was no mortality, and the mean length of hospital stay was 16 days.

CONCLUSIONS

Bullhorn and bullfighting injuries frequently have a multimechanistic origin which goes beyond a pure penetrating trauma. Associated blunt and STI were common in our series, and the overall prognosis of patients admitted to hospital was good.

Bladder neck rupture following perineal bull horn injury: a surgical challenge

Pelvic-abdominal injuries caused by goring are serious lesions which require rapid diagnosis and urgent treatment in the context of a polytraumatized patient. The simultaneous rupture of both the bladder and the prostatic-membranous urethra occurs in 10%–29% of males with pelvic fractures but bladder neck injuries in adults are rarer. Unstable pelvic fractures, bilateral fractures of the ischiopubic branches (also referred to as fractures from falling astride) and the diastasis of the pubic symphysis are those that have the greatest likelihood of injuring both the posterior urethra and the bladder. We present a case of perineal bull horn injury with muscle laceration, bone fractures, scrotal avulsion and rupture of the bladder neck involving the right ureter which required two operations to be repaired.