Injuries sustained by dog walkers could be costing the UK NHS around £23 million a year, a new study suggests.
And a rise in dog ownership could lead to more wrist and hand injuries linked to walking dogs on leads, academics suggested.
Experts from Raigmore Hospital in Inverness and Sengkang General Hospital in Singapore said that hand and wrist injuries linked to dog walking are an "understudied topic" as they set out to examine work in the field.
They conducted a review of five US studies pertaining to almost 500,000 injuries.
Almost three quarters (74%) of the injuries were among women and three in 10 (31%) were among people over the age of 65.
Of these injuries, some 110,000 were related to hand or wrist injuries.
The research team found that broken fingers were the most common injury.
And being pulled by a leash was the most common cause of a "direct dog-related injury", according to the review, which has been published in the journal Injury Prevention.
Researchers said that the cost of treating hand and wrist injuries is influenced by several factors.
After examining the cost of fixing various fractures and casts for broken bones, they wrote: "The potential annual cost of managing dog walking-related distal radius fractures in the NHS in England could exceed £23 million annually."
They stressed that the total economic cost cannot be derived from the cost of treating broken bones because these fractures and breaks will also potentially lead to a loss in productivity with people out of work as a result.
"This review highlights a significant number of dog walking-related hand and wrist injuries, particularly in the elderly and female population.
While finger fractures were the most frequently reported injury, the cost analysis in this review focused on distal radius fractures due to their substantial economic impact.
We estimated the potential annual cost of dog walking-related wrist fractures in the UK to exceed £23 million.
Preventative measures, including safer leash practices and public safety guidance, should be implemented to reduce injury risk."
The authors highlight how in the UK there are around 8.5 million dogs, or one dog for every seven to eight people.
They added: "Policies should teach dog owners optimal dog walking practices to minimise injuries and enforce adequate dog training to reduce the risk of dogs injuring the person walking them."