Bicycle incidents in children--abdominal trauma and handlebars.

Objectives: To investigate the frequency and causes of bicycle related abdominal injuries in children and to examine the pattern of presentation.

Design: The study was a prospective study of bicycle related injury in children less than 15 years of age presenting to two paediatric hospitals (15 April-30 June 1992) and three general hospitals (1 August 1991-30 June 1992).

Results: In a series of 813 children, 41 sustained non-penetrating abdominal trauma due to a bicycle incident. In 21 cases, handlebar trauma was responsible. Ten of these children suffered life-threatening intra-abdominal injury. Handlebars with no plastic or foam covering of the metal ends were involved in all ten cases. In several of these cases, presentation to hospital was delayed and in others confirmation of the extent of injury took up to 48 hours. The length of hospital stay for those with significant intra-abdominal organ damage ranged from two to 156 days.

Conclusions: Intra-abdominal trauma must be considered when dealing with children who are victims of bicycle trauma. Impact with handlebars may have occurred and some form of padded protection of handlebar ends is recommended unless their design can be suitably modified.