Fracture patterns in bicycle accidents: A descriptive national cohort study of fractures sustained in bicycle accidents in the Swedish Fracture Register 2015-2022.

Introduction: Bicycle accidents account for the majority of traffic-related accidents in Sweden. Despite the widespread everyday use of bicycles, little is known about the fracture panorama resulting from bicycle accidents. This study analysed the fracture patterns of bicycle accidents in Sweden in regard to fracture type, sex, age, and type of bicycle.

Material And Methods: We retrieved data from the Swedish Fracture Register on all fractures caused by bicycle accidents between 2015 and 2022. The study population was comprised of both children and adults who had sustained one or more fractures in a bicycle accident as registered in the Swedish Fracture Register.

Results: We included 33,384 fractures (25,960 in adults and 7424 in children) in 30,815 patients, with a dominance of fractures in men. The mean age at fracture was 41.6 years (SD 23). The majority of fractures (62.7 %, n = 20,932) were sustained via a low energy mechanism. Overall, the most commonly fractured body parts were the forearm (35.2 %, n = 11,747), the hand (15.6 %, n = 5,196) and the clavicle (13.7 %, n = 4,558). In children, fractures of the forearm (56.8 %, n = 4,215) clearly dominated, followed by the hand (11.7 %, n = 868), and the humerus (11.0 %, n = 816). In adults, the top 3 fracture locations were the forearm (29.0 %, n = 7,532), the hand (16.7 %, n = 4,328), and the clavicle (15.7 %, n = 4,086). Mountain bikes and road bikes showed a fracture panorama that was very similar with a predominance of fractures to the clavicle. Fractures were more common during the warm season.

Conclusion: The main finding is that bicyclists predominantly sustained fractures of the upper limb via low energy mechanisms. The fracture panorama differed by age, sex, and type of bicycle.