At Times, Hunters Should Beware. Trauma from Wild Boar Encounters During Hunting: A Nationwide Survey in Germany with a Systematic Literature Review

Background/Objectives: Wild boar (Sus scrofa) populations have expanded markedly across Europe, increasing human–wild boar encounters and hunting-related injuries. Existing knowledge derives mainly from isolated case reports or fatality analyses. This nationwide study characterizes injury patterns, management pathways, outcomes, and contextual risk factors associated with wild boar attacks during organized hunting in Germany and complements these data with a systematic literature review. Methods: Injured hunters were recruited via major German hunting journals. Structured physician-led telephone interviews captured demographics, hunting exposure, event characteristics, anatomical injury patterns, management strategies, complications, outcomes, and post-injury adaptations. Injuries were categorized as closed, open outpatient, or open inpatient. Descriptive statistics, Chi-square tests, linear regression models, and ANCOVA were applied. A systematic literature review (PRISMA 2020) supplemented the primary dataset. Results: A total of 101 hunters were included, predominantly experienced male dog handlers injured during close-range tracking operations. Lower-extremity penetrating injuries dominated. Significant associations with injury severity included situational context (p = 0.028), sex of the injuring boar (p = 0.023), and time to first help (p = 0.036). Open injuries requiring inpatient care frequently involved extensive soft-tissue destruction, vascular injury, surgical intervention, infectious complications, and prolonged recovery. Treatment duration strongly predicted work absenteeism across all injury categories, with progressively steeper regression slopes in more severe injuries (interaction p < 0.001). No fatalities occurred, and all participants resumed hunting. Most participants expressed need for improved first-aid training. Conclusions: Hunting-associated wild boar attacks constitute a distinct form of penetrating trauma with deceptively small external wounds and substantial underlying tissue damage. This study provides the largest structured clinical dataset to date and, combined with a systematic literature review, informs prevention strategies, first-aid preparedness, and surgical management in modern trauma systems.