The true spectrum of handlebar injuries in children

Abstract

Objective: The full spectrum and incidence of injuries caused by handlebar impact in children has not been adequately described in the literature. While bicycle handlebars are known to cause significant intra-abdominal injury, there are a number of other vehicle types using handlebars which have not been fully explored for the incidence and severity of handlebar trauma. Method: A prospectively identified trauma registry was searched for all trauma events relating to vehicles equipped with handlebars from July 2000 through June 2008. Patients with injuries involving handlebar impact were identified and studied in greater detail. Results: Of 1565 traumas identified, there were 179 children with a handlebar injury. Bicycles were the most common vehicle used (78%), followed by motorbikes (12%), scooters and quadbikes. While the majority of ‘handlebar’ children had abdominal impact (63%), a significant number of traumas involved impact to other regions including the face (12%), thigh, perineum, neck and chest. Patient age and vehicle type were associated; in children riding scooters, the most common site of handlebar impact was the face (55%), while 80% of all ‘handlebar’ patients aged under 6 years had facial impact. However, within each vehicle type there was no age difference between ‘handlebar’ and ‘non-handlebar’ patients (overall p = 0.47). Median length of stay was significantly higher amongst children with handlebar impact. Conclusions: Our findings support previous reports of the seriousness of handlebar injuries. In addition to the high risk of abdominal organ injury, a range of vehicles equipped with handlebars can cause serious injuries to other body regions.