Bicycle-Related Injuries of the Upper Extremity

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopaedic Surgery National University Hospital, Singapore

2 Department of Orthopaedic Surgery, National University Hospital, Singapore

3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Abstract

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 quar ter required surgical intervention.
Level of evidence: III

Keywords

Main Subjects

References

  1. Where we ride: analysis of bicycling in American cities. report on 2013 American Community Survey data by the league of american bicyclists. Available at: https://bikeleague.org/sites/default/files/ACS_report_2014_forweb_edit.pdf. Accessed, 2014.
  2. Pucher J, Buehler R. Walking and Cycling for Healthy Cities. Journal of the Transportation Research Board. 2008; 58-65.
  3. Singapore sees cycling boom amid COVID-19, with increased ridership and bicycle sales. Available at: https://www.channelnewsasia.com/singapore/covid-19-cycling-popularity-bicycle-sales-shared-bikes-631621. Accessed 25 Aug, 2020.
  4. JUSTIN ONG . The Big Read: Road wars — will the conflict between drivers and cyclists ever end? Available at: https://www.todayonline.com/big-read/big-read-road-wars-will-conflict-between-drivers-and-cyclists-ever-end. Accessed 9 January, 2021.
  5. Oja P, Vuori I, Paronen O. Daily walking and cycling to work: their utility as health-enhancing physical activity. Patient Educ Couns. 1998;33:S87-94. doi: 10.1016/s0738-3991(98)00013-5.
  6. Oja P, Titze S, Bauman A, et al. Health benefits of cycling: a systematic review. Scand J Med Sci Sports. 2011;21(4):496-509. doi: 10.1111/j.1600-0838.2011.01299.x.
  7. Mehan TJ, Gardner R, Smith GA, McKenzie LB. Bicycle-related injuries among children and adolescents in the United States. Clin Pediatr (Phila). 2009;48(2):166-73. doi: 10.1177/0009922808324952.
  8. Wee JH, Park JH, Park KN, Choi SP. A comparative study of bike lane injuries. J Trauma Acute Care Surg. 2012;72(2):448-53. doi: 10.1097/TA.0b013e31823c5868.
  9. Lloyd R, Tucker A, Archbold P, Eames N. The changing face of serious bicycle injuries from a UK Regional Trauma Centre. Journal of Science and Cycling. 2017;6(3).
  10. Thompson MJ RF. Bicycle-related injuries. Am Fam Physician. 2001;63(10):2007-14...
  11. L Peter, CC Hong, P Daniel, R Aoyama, D Murphy, WS Kuan. Bicycle-Related Injuries in Paediatric Patients. Annals of the Academy of Medicine, Singapore. 2018;47:424-428.
  12. S. Bicycling injuries. Curr Sports Med Rep. 2013;12(5):337-45. doi: 10.1249/JSR.0b013e318 2a4bab7.
  13. Goldstein Y, Dolkart O, Kaufman E,et al. Bicycle-Related Shoulder Injuries: Etiology and the Need for Protective Gear. Isr Med Assoc J. 2016;18(1):23-6..
  14. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58(4):453-8.
  15. Chen WS, Dunn RY, Chen AJ, Linakis JG. Epidemiology of nonfatal bicycle injuries presenting to United States emergency departments, 2001–2008. Academic emergency medicine. 2013;20(6):570-5. doi: 10.1111/acem.12146.
  16. The Straits Times. Parliament: About 2,600 food delivery riders apply to switch from e-scooters to e-bikes. Available at: https://www.straitstimes.com/politics/parliament-about-2600-food-delivery-riders-apply-to-switch-from-e-scooters-to-e-bikes. Accessed November 2022.
  17. King CC, Liu M, Patel S, Goo TT, Lim WW, Toh HC. Injury patterns associated with personal mobility devices and electric bicycles: an analysis from an acute general hospital in Singapore. Singapore Med J. 2020;61(2):96. doi: 10.11622/smedj.2019084.
  18. Liew YK, Wee CP, Pek JH. New peril on our roads: a retrospective study of electric scooter-related injuries. Singapore Med J. 2020;61(2):92. doi: 10.11622/smedj.2019083.
  19. Toh Ting Wei. 417 road accidents involving cyclists and e-bike users last year, slight drop from 2018. Available at: https://www.straitstimes.com/singapore/transport/417-road-accidents-involving-cyclists-and-e-bike-users-last-year-slight-drop. Accessed 9 January,2021
  20. Reynolds CC, Harris MA, Teschke K, Cripton PA, Winters M. The impact of transportation infrastructure on bicycling injuries and crashes: a review of the literature. Environ Health. 2009;8(1):1-9. doi: 10.1186/1476-069X-8-47.
  21. Lusk AC, Furth PG, Morency P, Miranda-Moreno LF, Willett WC, Dennerlein JT. Risk of injury for bicycling on cycle tracks versus in the street. Inj Prev. 2011;17(2):131-5. doi: 10.1136/ip.2010.028696.
  22. Loo BP, Tsui KL. Bicycle crash casualties in a highly motorized city. Accid Anal Prev. 2010;42(6):1902-7. doi: 10.1016/j.aap.2010.05.011.
  23. Burkhart TA, Andrews DM. The effectiveness of wrist guards for reducing wrist and elbow accelerations resulting from simulated forward falls. J Appl Biomech. 2010;26(3):281-9. doi: 10.1123/jab.26.3.281.
  24. Hagel B, Pless IB, Goulet C. The effect of wrist guard use on upper-extremity injuries in snowboarders. Am J Epidemiol. 2005;162(2):149-56. doi: 10.1093/aje/kwi181.
  25. Kendall M, Post A, Rousseau P, Hoshizaki T. The effect of shoulder pad design on reducing peak resultant linear and rotational acceleration in shoulder-to-head impacts. InMechanism of concussion in sports 2014. ASTM International. DOI:10.1520/STP155220120150
  26. Richards D, Ivarsson BJ, Scher I, Hoover R, Rodowicz K, Cripton P. Ice hockey shoulder pad design and the effect on head response during shoulder-to-head impacts. Sports Biomech. 2016;15(4):385-96. doi: 10.1080/14763141.2016.1163414.
  27. Harris DA, Spears IR. The effect of rugby shoulder padding on peak impact force attenuation. Br J Sports Med. 2010;44(3):200-3. doi: 10.1136/bjsm.2008.047449.
  28. Pain MT, Tsui F, Cove S. In vivo determination of the effect of shoulder pads on tackling forces in rugby. J Sports Sci. 2008;26(8):855-62. doi: 10.1080/02640410801910319.
  29. Robinson LS, Brown T, O’Brien L. Profile and cost of sport and exercise-related hand and wrist injuries with Emergency Department presentation J Sci Med Sport. 2020;23:683-689.https://doi.org/10.1016/j.jsams.2020.01.007
  30. Robinson LS, Sarkies M, Brown T, O’Brien L. Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review. Injury. 2016;47:2614-2626. https://doi.org/10.1016/j.injury.2016.09.041
  31. Robinson LS, Brown T, O’Brien L. Cost, profile, and postoperative resource use for surgically managed acute hand and wrist injuries with emergency department presentation J Hand Ther.2020;S0894-1130:30006-30005. https://doi.org/10.1016/j.jht.2019.12.007
  32. Rosberg HE, Carlsson KS, Dahlin LB. Prospective study of patients with injuries to the hand and forearm: costs, function, and general health. Scand J Plast Reconstr Surg Hand Surg. 2005;39(6):360-9. https://doi.org/10.1080/02844310500340046
  33. Goh SS, Leong XY, Cheng JY, Teo LT. Electronic Bicycles and Scooters: Convenience at the Expense of Danger? Ann Acad Med Singapore. 2019;48(4):125-8.
  34. K Beckwith VJ, K Kalaiselvan, S Ganapathy. Bicycle injuries among the paediatric population at an emergency department in Singapore Singapore Med J. 2019;60:343–346. doi: 10.11622/smedj.2019009
  35. Tan WT CJ, Foo JM. A 5-year profile of trauma admissions to the surgical intensive care unit of a tertiary hospital in Singapore.Ann Acad Med Singapore. 2010;39:363-367. https://doi.org/10.47102/annals-acadmedsg.V39N5p363
The Archives of Bone and Joint Surgery
Volume 10, Issue 12
December 2022
Pages 1030-1036

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History

  • Receive Date: 29 June 2021
  • Revise Date: 03 June 2022
  • Accept Date: 14 June 2022

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