Objectives: Increasing bicycle ridership is accompanied by ongoing bicycle-related accidents in many urban cities. There is a need for improved understanding of patterns and risks of urban bicycle usage. We describe the injuries and outcomes of bi cycle-related trauma in Boston, Massachusetts, and determine accident-related factors and behaviors associated with injury severity. Methods: We conducted a retrospective review via chart review of 313 bicycle-related injuries presenting to a Level 1 trauma center in Boston, Massachusetts. These patients were also surveyed regarding accident-related factors, personal safety practices, and road and environmental conditions during the accident. Results: Over half of all cyclists biked for commuting and recreational purposes (54%), used a road without a bike lane (58%), and a majority wore a helmet (91%). The most common injury pattern involved the extremities (42%) followed by head injuries (13%). Bicycling for commuting rather than recreation, cycling on a road with a dedicated bicycle lane, the absence of gravel or sand, and use of bicycle lights were all factors associated with decreased injury severity (p<0. 05). After any bicycle injury, the number of miles cycled decreased significantly regardless of cycling purpose. Conclusion: Our results suggest that physical separation of cyclists from motor vehicles via bicycle lanes, regular cleaning of these lanes, and usage of bicycle lights are modifiable factors protective against injury and injury severity. Safe bicycling practices and understanding of factors involved in bicycle-related trauma can reduce injury severity and guide effective public health initiatives and urban planning.

Herein, we reviewed the pattern and mechanisms of injuries resulting from bicycle accidents in Tehran. During one year of trauma registry in six general hospitals, 8,000 trauma patients who had sustained injuries within a week before admission and hospitalized for more than 24 hours were studied. Bicycle injuries comprised 2.1% (n=170) of all cases admitted during the studied period. Males were injured more often than females (M: F ratio=8:1). Seventy-seven point one percent of the patients were younger than 20 years. None of the patients had used helmets while being injured. A considerable proportion of accidents occurred between 6 and 8 PM. The most common season of bicycle accidents were summer (55.2%) and spring (24.8%). Seventy-six (44.7%) patients sustained injuries in collision with other vehicles (cars, motorcycles, etc). Four patients died of severe head injuries. Thirteen (8.1%) patients had injury severity score of >16 (severe injury). The mean duration of hospital stay was 5.2 (range: 1-52) days. Due to the fatal nature of head injuries and high incidence of fall/overturn injuries among bicycle riders, helmets should be worn by all riders, particularly young children. In addition, allocating a separate cycle path may reduce severe bicycle injuries.

Background: In recent years, the increasing popularity of cycling for commuting and leisure has led to a corresponding increase in bicycle-related injuries. However, there is a lack of extensive analysis of bicycle-related injuries to the upper limb in the literature. Methods: A retrospective review of all patients with conventional bicycle-related injuries of the upper limb was performed. Data on demographics, mechanisms of injury, region of injury, fracture type, management type, and length of hospital stay were extracted and analyzed. Results: A total of 177 of 733(24%) patients with bicycle-related upper limb injuries were identified. The most common mechanism of injury was a collision with another vehicle (60%). Frequently affected regions were the shoulder (48%), hand (19%), and wrist (19%). Eighty-eight (50%) patients sustained bony injuries, while the remainder (50%) had isolated soft tissue injuries. Fifty-three (30%) patients required a mean of 3. 9 days of hospitalization, whereas 13 (25%) patients required high dependency or intensive care unit treatment. Surgical interventions were required in 47 (27%) patients. Conclusion: Bicycle-related injuries to the upper limb are common and result in significant morbidity. The most common regions affected are the shoulder, wrist, and hand. Most of the injuries were caused by collisions with other vehicles. A third of affected patients required hospitalization, and a quarter required surgical intervention.

Blunt trauma abdomen is a very common entity but traumatic abdominal wall hernia is not that common. Herniation through abdominal wall usually occurs following trauma with seat belt, motor cycle, bicycle handle bar etc. Handlebar hernia is a less known variety of traumatic abdominal wall hernia as a consequence of injury with handlebar of a bicycle. It is difficult to diagnose and one should have high index of suspicion. Management in traumatic abdominal wall hernia is individualized based on various factors. We herein present an interesting case of a14-year-old boy, who sustained blunt trauma abdomen from bicycle handlebar leading to triple herniation and perforation of the small bowel and hematoma of the mesentery. Patient was resuscitated and operated with a favorable outcome. Blunt trauma abdomen is a very common and the possibility of traumatic abdominal wall hernia should always be borne in mind.