Abstract
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. Pasteurella spp. predominated, Pasteurella canis in dog bites and Pasteurella multocida 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.