Riding a bicycle: do we need more than a helmet?

Background: To assess pediatric bicycle-related traumatization in view of types of injuries, incidence and modes of prevention.

Methods: Retrospective study of pediatric cases admitted to the pediatric intensive care unit of a university-affiliated level II trauma hospital in Israel over 12 consecutive years.

Results: Forty-six patients (three girls, 43 boys) with bicycle-related injuries formed 1% of the total pediatric intensive care unit admissions during the study period. The number of patients with bicycle-related injuries increased significantly during recent years (1996-2001 vs 2002-07: P = 0.003). Most of the cases presented abdominal injuries (54.4%) followed by head (32.6%) and chest (13%) injuries. The median age of patients with abdominal trauma was significantly lower in comparison to patients with other types of injuries (P = 0.002). Abdominal cases required longer hospitalization compared with other patients (P = 0.003). Falling from a bicycle was the main mechanism of injury in abdominal cases (88%) (P = 0.003). Motor vehicle impacts were the main mechanism of injury in patients with head (60%) and chest (66.6%) trauma.

Conclusion: The incidence of severe bicycle-related injuries requiring intensive care hospitalization is increasing and abdominal trauma forms the main portion of those injuries. We suggest introducing a trunk-protective measure for young bicyclists. Exact information on the mechanism of the injury is important for evaluating the injured patient more accurately.