Introduction The purpose of this study was to investigate the characteristics and the outcome of bicycle injuries in paediatric patients according to the living environment, and to create guidelines for injury prevention. Patients The evaluation was performed in part based on hospital database of 1803 in- and out-patient children treated at the Paediatric Surgical Department of Pécs/Hungary between 2000 and 2006, and at the Department of Paediatric Surgery at the Heim Pal Hospital Budapest between 2004 and 2006. Additionally questionnaires were mailed to the patients’ families to gain follow-up information. We analysed three groups according to demographic density (village, midsize town and large town). Results We found, that poor road quality played an important role as a contributing factor of injuries in villages. The number of bicycle spoke-injuries was higher in villages (13%), than in midsize towns (4.6%) and the large town (9.9%). In villages, 5% of children injured wore a helmet; this rate was 9% in midsize towns and 9.1% in the large town. Head injury was more common in villages, while in midsize towns and the large town arm injuries proved to be predominant. Discussion Prevention strategies targeting bicycle injuries in children should take into account the population density. This analysis revealed a substantial difference in the use of safety devices, and in the characteristics of injuries occurring in villages, indicating that there is a need for special attention regarding this higher risk population.
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