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Salzano G, Maffia F, Vaira LA, Fusco R, Albanese M, Crimi S, Cucurullo M, Maglitto F, Maugeri C, Petrocelli M, Pitino F, Priore P, Roccia F, Tel A, Baietti AM, Bianchi A, Biglioli F, Copelli C, De Riu G, Nocini PF, Ramieri G, Robiony M, Valentini V, Califano L. The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study. J Clin Med 2024; 13:5195. [PMID: 39274410 PMCID: PMC11395837 DOI: 10.3390/jcm13175195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 08/28/2024] [Accepted: 08/30/2024] [Indexed: 09/16/2024] Open
Abstract
Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.
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Affiliation(s)
- Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy
| | - Francesco Maffia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy
- PhD Program of the Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Roberta Fusco
- Oncology Medical and Research Development Division, Igea SpA, 80013 Naples, Italy
| | - Massimo Albanese
- Department of Oral and Maxillofacial Surgery, University of Verona, 37129 Verona, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Marco Cucurullo
- Operative Unit of Maxillo-Facial Surgery, Head and Neck Department, San Paolo Hospital of Milan, 20122 Milan, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Claudia Maugeri
- Department of Surgical Sciences, Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Marzia Petrocelli
- Oral and Maxillo-Facial Unit, AUSL Bologna Bellaria-Maggiore Hospital, 40133 Bologna, Italy
| | - Francesca Pitino
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Paolo Priore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabio Roccia
- Department of Surgical Sciences, Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Alessandro Tel
- Head-Neck and NeuroScience Department, Clinic of Maxillofacial Surgery, University Hospital of Udine, 33100 Udine, Italy
| | - Anna Maria Baietti
- Oral and Maxillo-Facial Unit, AUSL Bologna Bellaria-Maggiore Hospital, 40133 Bologna, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Federico Biglioli
- Operative Unit of Maxillo-Facial Surgery, Head and Neck Department, San Paolo Hospital of Milan, 20122 Milan, Italy
| | - Chiara Copelli
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Pier Francesco Nocini
- Department of Oral and Maxillofacial Surgery, University of Verona, 37129 Verona, Italy
| | - Guglielmo Ramieri
- Department of Surgical Sciences, Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Massimo Robiony
- Head-Neck and NeuroScience Department, Clinic of Maxillofacial Surgery, University Hospital of Udine, 33100 Udine, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy
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Boschetti CE, Montella E, Magliulo R, Molo E, Canet López E, Guida D, Borrelli S, Gargiulo M, Mattarocci M, Carotenuto A, Facciuto E, Petrocelli M, Norino G, Cristofaro MG, Barca I, Nastro Siniscalchi E, Lo Giudice G, Chirico F, Santagata M, Tartaro G. New generation vehicles: the impact of electric scooter trauma on the severity of facial fractures assessed by FISS score. A multicentre study. Br J Oral Maxillofac Surg 2024; 62:626-631. [PMID: 39019685 DOI: 10.1016/j.bjoms.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/05/2024] [Accepted: 05/18/2024] [Indexed: 07/19/2024]
Abstract
With the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals. Fifty patients (mean age was 34.76 years) from January 2020 to January 2024 were enrolled. The severity of trauma was evaluated by the Facial Injury Severity Scale (FISS) by Bagheri et al. Most of the accidents occurred during the day and the weekend in spring or summer; 24 drivers collided with infrastructures or pedestrians, while 26 involved other vehicles. A total of 33 vehicles were rented, and 17 were privately owned. A total of 43 subjects were not wearing helmets, five patients were drunk, and three patients took drugs. In order of frequency, the facial fractures involved: zygomatico-maxillary-orbital complex (ZMOC) (n = 16), mandibular condyle (n = 13), nasal bone (n = 11), orbit floor (n = 8), and mandibular body (n = 7). Fractures such as Le Fort I (n = 4), naso-orbito-ethmoidal NOE (n = 4) and mandibular ramus (n = 4) were less common. Other types of facial fracture were rare. Thirty patients reported multiple facial fractures. The vast majority of the cases showed a low severity grade FISS score. Fifteen patients suffered polytrauma. The mean hospitalisation time was 8.3 days. As accidents with electric scooters are increasing, it is important to characterise the most frequent facial fractures to improve patient management and encourage the introduction of new road rules.
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Affiliation(s)
- Ciro Emiliano Boschetti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Roberta Magliulo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Elena Molo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Emilio Canet López
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - David Guida
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | | | | | - Enzo Facciuto
- Maxillofacial Surgery Unit, "Ospedale del mare" Hospital, Naples, Italy
| | - Marzia Petrocelli
- Oral and Maxillofacial Surgery Unit, "Bellaria-Maggiore" Hospital, Bologna, Italy
| | - Giovanna Norino
- Oral and Maxillofacial Surgery Unit, "Bellaria-Maggiore" Hospital, Bologna, Italy
| | - Maria Giulia Cristofaro
- Department of Experimental and Clinical Medicine, Maxillofacial Surgery Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Ida Barca
- Department of Experimental and Clinical Medicine, Maxillofacial Surgery Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Enrico Nastro Siniscalchi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, "G. Martino" University Hospital, University of Messina, Messina, Italy
| | - Giorgio Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, "G. Martino" University Hospital, University of Messina, Messina, Italy
| | - Fabrizio Chirico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Santagata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
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Rzepczyk S, Pawlas K, Borowska-Solonynko A, Karnecki K, Cywka T, Moskała A, Skowronek R, Majdanik S, Szeremeta M, Dropiewska-Nowak A, Jurczyk A, Żaba C, Jurek T. Fatal traffic accidents involving electric scooters in Poland in 2019-2023. Injury 2024; 55:111836. [PMID: 39208682 DOI: 10.1016/j.injury.2024.111836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 08/05/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
With the introduction of mobile applications that allow short-term rentals, electric scooters (e-scooters) are gaining popularity as a means of micromobility in urban areas. The aim of the study was to assess the circumstances and causes of death in traffic accidents involving electric scooters in Poland. The inclusion criteria for the study were met by 9 cases (7 M,2F; mean age: 40.3 years). Accidents usually occur during working days during the warm months, especially during the morning traffic rush hour. Usually, these accidents involved another vehicle (4/9 cases). In addition, the victim was most often the driver (8/9 cases) and rarely uses a helmet (1/9 cases). In only two cases did the test reveal the presence of alcohol in the blood at the time of the accident. In studied cases, head injuries occurred in every case, and injuries to the limbs and chest occurred in more than half of the cases. Within the head, in addition to minor injuries like bruises and epidermal abrasions, skull fractures, and intracranial bleedings predominated. Similar minor injuries were also observed in the extremities, with significant fractures observed only in the lower extremities. Among chest injuries, lung contusions predominated. The most common cause of death was craniocerebral injury (6/9 cases), but there were two deaths each from chest injuries and polytrauma. To increase the safety of e-scooter users, it is recommended that measures be taken to educate users about the potential risks of using the vehicle and that measures be taken to increase the use of helmets, e.g. through legislative action. Further studies involving larger study groups are needed to assess the correlation between potential risk factors and the fatal outcome of the accident.
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Affiliation(s)
- Szymon Rzepczyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10 60-806 Poznań, Poland.
| | - Ksenia Pawlas
- Department of Forensic Medicine, Faculty of Medicine, Wroclaw Medical University, Jana Mikulicza-Radeckiego 4 50-345 Wrocław, Poland
| | | | - Karol Karnecki
- Department of Forensic Medicine, Medical University of Gdańsk, Marii Skłodowskiej-Curie 3a 80-210 Gdańsk, Poland
| | - Tomasz Cywka
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8B 20-090 Lublin, Poland
| | - Artur Moskała
- Department of Forensic Medicine, Jagiellonian University, Grzegórzecka 16 31-531, Kraków, Poland
| | - Rafał Skowronek
- Department of Forensic Medicine, Medical University of Silesia in Katowice, Medyków 18 40-752 Katowice, Poland
| | - Sławomir Majdanik
- Department of Forensic Medicine Pomeranian Medical University in Szczecin, Powstanców Wielkopolskich 72 70-111, Szczecin, Poland
| | - Michał Szeremeta
- Department of Forensic Medicine, Medical University of Bialystok, Waszyngtona 13 15-269 Białystok, Poland
| | - Anna Dropiewska-Nowak
- Department of Forensic Medicine, Ludwik Rydygier Collegium Medicum, Curie Skłodowskiej 9 85-094 Bydgoszcz, Poland
| | - Agnieszka Jurczyk
- Department of Forensic Medicine, Medical University of Lodz, Sędziowska 18a 91-304 Łódź, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10 60-806 Poznań, Poland
| | - Tomasz Jurek
- Department of Forensic Medicine, Faculty of Medicine, Wroclaw Medical University, Jana Mikulicza-Radeckiego 4 50-345 Wrocław, Poland
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Kayaalp ME, Kilic NC, Kandemir I, Bayhan M, Eceviz E, Kayaalp ME. [Electric scooter-associated orthopedic injuries cause long absence from work, regret and are emerging as a major cause of hip fractures in young individuals: a comprehensive study from a regional trauma center in a densely populated urban setting]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:587-596. [PMID: 38888752 DOI: 10.1007/s00132-024-04523-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE This study aimed to give a full spectrum of orthopedic injuries associated with electric scooter (e-scooter) use and analyze related factors, report on follow-up data from the patient's perspective and make a comparative etiological analysis of young adult hip fractures. METHODS A total of 851 consecutive patients were admitted to the Emergency Department following e‑scooter injuries between January 2021 and July 2022, of whom 188 had 214 orthopedic injuries. The demographics, injury, and incident characteristics of these patients were collected. All fractures were classified as per the AO/OTA classification. Two groups were created as operatively or conservatively treated patients and data were comparatively analyzed. Follow-up examination incorporated a survey using binary questions on patients' perspectives. An etiological comparative analysis of hip fractures in young adults admitted to the same center between 2016 and 2022 was conducted. RESULTS The median patient age was 25. Inexperienced drivers constituted 32% of the injured. The protective gear use rate was at 3%. Higher speed (p = 0.014) and age (p = 0.011) were significantly associated with operative treatment. A total of 39% of the operated patients could not return to preinjury physical function, while 74% regretted using an e‑scooter. The most common etiological factor for traumatic young hip fractures was fall from a height between 2016 and 2020, whereas it became e‑scooter accidents in 2021-2022. CONCLUSION The rate of e‑scooter-related operative treatment is high and leaves the patient in regret (84%) and a physically limited condition (39%). A speed limit of ≤ 15 km/h could decrease the rate of operative injuries. The e‑scooter was identified as the top etiological factor in the last 2 years for traumatic young hip fractures. LEVEL OF EVIDENCE II, Diagnostic cohort study.
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Affiliation(s)
- Mahmut Enes Kayaalp
- Abteilung für Orthopädie und Traumatologie, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Türkei.
| | - Nazim Canberk Kilic
- Abteilung für Orthopädie und Traumatologie, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Türkei
| | - Ibrahim Kandemir
- Abteilung für Orthopädie und Traumatologie, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Türkei
| | - Mazlum Bayhan
- Abteilung für Orthopädie und Traumatologie, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Türkei
| | - Engin Eceviz
- Abteilung für Orthopädie und Traumatologie, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Türkei
| | - Mahmut Enes Kayaalp
- Abteilung für orthopädische Chirurgie, Universität von Pittsburgh, Pittsburgh, USA
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Spota A, Granieri S, Ferrario L, Zamburlini B, Frassini S, Reitano E, Cioffi SP, Altomare M, Bini R, Virdis F, Chiara O, Cimbanassi S. Injury Patterns of Electric-Scooter Related Trauma: A Systematic Review With Proportion Meta-Analysis. Am Surg 2024; 90:1702-1713. [PMID: 38532248 DOI: 10.1177/00031348241241682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Electric scooter (ES)-related injuries are increasing but poorly described. Clinicians need more information to be prepared for these patients. We supposed two prevalent patterns of patients: mildly injured (predominant upper-limb injuries) and severely injured (predominant head trauma). This study aims to understand the frequency of ES-related injuries and patients' characteristics despite the heterogeneity of data currently available. A systematic review with a proportion meta-analysis was conducted on studies with a multidisciplinary description of ES-related injuries in adult patients (PROSPERO-ID: CRD42022341241). Articles from inception to April 2023 were identified in MEDLINE, Embase, and Cochrane's databases. The risk of bias was evaluated using ROBINS-I. Twenty-five observational studies with 5387 patients were included in the meta-analysis, depending on reported data. Upper-limb (31.8%) and head (19.5%) injuries are the most frequent (25/25 studies included). When injured while riding, 19.5% of patients are intoxicated with drugs/alcohol, and only 3.9% use a helmet, increasing the possibility of severe injuries. About 80% of patients are victims of spontaneous falls. Half of the patients self-present to the ED, and 69.4% of cases are discharged directly from the ED. Studies' limitations include an overall moderate risk of bias and high heterogeneity. Electric scooter-related accidents are commonly associated with upper-limb injuries but often involve the head. Spontaneous falls are the most common mechanism of injury, probably related to frequent substance abuse and helmet misuse. This hot topic is not adequately investigated due to a lack of data. A prospective registry could fill this gap.
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Affiliation(s)
- Andrea Spota
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Tissue Bank and Therapy, ASST GOM Niguarda, Milan, Italy
| | - Stefano Granieri
- General Surgery Unit, ASST-Brianza, Vimercate Hospital, Vimercate, Italy
| | - Luca Ferrario
- General Surgery Department, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milano, Italy
- Department of Biomedical and Clinical Sciences "Luigi Sacco," Università Degli Studi di Milano, Milano, Italy
| | | | - Simone Frassini
- Unit of General Surgery I, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
- General Surgery Residency Program, University of Pavia, Pavia, Italy
| | - Elisa Reitano
- Department of General Surgery, Nouvel Hôpital Civil, CHRU-Strasbourg, Strasbourg, France
| | - Stefano Pb Cioffi
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Surgical Sciences, University of Rome Sapienza, Roma, Italy
| | - Michele Altomare
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Surgical Sciences, University of Rome Sapienza, Roma, Italy
| | - Roberto Bini
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
| | | | - Osvaldo Chiara
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Pathophysiology and Transplantation, State University of Milan, Milano, Italy
| | - Stefania Cimbanassi
- Acute care surgery and trauma, ASST GOM Niguarda, Milan, Italy
- Department of Pathophysiology and Transplantation, State University of Milan, Milano, Italy
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Rashid J, Sritharan R, Wu S, McMillan K. E-scooter-related dental injuries: a two-year retrospective review. Br Dent J 2024:10.1038/s41415-024-7345-4. [PMID: 38693336 DOI: 10.1038/s41415-024-7345-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 05/03/2024]
Abstract
Introduction In June 2020, the United Kingdom (UK) published guidance on electric scooter (e-scooter) use to ease transport congestion and reduce pollution. This study aims to examine dental injuries sustained during the two years following initiation of the trial.Methods The research was conducted at a UK, Level 1, supra-regional major trauma centre. All eligible patient records were analysed to identify e-scooter-related dental injuries to the following regions: teeth, periodontium, alveolus, palate, tongue, floor of mouth, frenum, buccal mucosa and lips. To assess significant associations between recorded variables, a Pearson's chi-square test was utilised.Results Of the 32 patients who experienced a total of 71 dental injuries, 46.5% (n = 33) affected teeth, predominantly upper central incisors (n = 17). 'Lacerations' (n = 32) and 'lips' (n = 30) were the most common type and site of soft tissue injuries, respectively. Unprovoked falls by riders accounted for 53.1% (n = 17) of the injuries. There was an overall increase in e-scooter-related dental injuries throughout the two-year period.Conclusion E-scooters have introduced an additional source of dental trauma. It is imperative health care professionals can also identify signs of head and non-dental injuries when managing such patients. Further studies are warranted allowing for better informed and optimised dental public health interventions.
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Affiliation(s)
- Junaid Rashid
- Dental Core Trainee, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK.
| | - Rajeevan Sritharan
- Junior Specialist Dentist, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Sophie Wu
- Dental Core Trainee, Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Kevin McMillan
- Consultant in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2GW, UK
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Linhart C, Jägerhuber L, Ehrnthaller C, Schrempf J, Kußmaul AC, Neuerburg C, Böcker W, Lampert C. E-scooter accidents-epidemiology and injury patterns: 3-year results from a level 1 trauma center in Germany. Arch Orthop Trauma Surg 2024; 144:1621-1626. [PMID: 38367063 PMCID: PMC10965700 DOI: 10.1007/s00402-024-05209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/18/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Since the introduction of e-scooters in Germany in 2019, they are becoming more and more popular and associated injuries have increased significantly. The aim of this study was to assess the injury patterns after e-scooter accidents. MATERIALS AND METHODS From May 2019 to October 2022, all consecutive patients who presented at our emergency department (ED) following e-scooter accidents were included in our study and retrospectively analyzed. RESULTS A total of 271 patients were included in our study. The mean age was 33 years. 38% of the patients were female and 62% were male. Most common injuries were traumatic brain injuries in 38% of the patients together with fractures affecting the upper limb (17%). An operative treatment was necessary in 40 patients. Most of the patients presented at night and about 30% were under the influence of alcohol. CONCLUSIONS Our study shows one of the largest cohort of patients suffering e-scooter accidents in Europe. Compulsory helmet use, stricter alcohol controls and locking periods could contribute significantly to safety.
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Affiliation(s)
- Christoph Linhart
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Ludwig Jägerhuber
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Christian Ehrnthaller
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Judith Schrempf
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Adrian Cavalcanti Kußmaul
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Carl Neuerburg
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Wolfgang Böcker
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Christopher Lampert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM) University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
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Markowitz M, Kholodovsky E, Constantinescu D, Weinerman J, Hernandez G, Dodds SD. The Impact of the City of Miami's Decision to Revoke Electric Scooter Company Permits on Orthopedic Trauma at a Level I Trauma Center. J Emerg Med 2024; 66:177-183. [PMID: 38290883 DOI: 10.1016/j.jemermed.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/14/2023] [Accepted: 10/22/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Since the introduction of electric-scooter (e-scooter) mobile applications, there has been a marked increase in e-scooter-related injury. On January 19, 2022, the City of Miami revoked permits to five major mobile applications for violation of safety protocols. OBJECTIVES The purpose of our study was to assess the effects of this notice on the orthopedic patients seen at our corresponding Level I trauma center. METHODS Institutional Review Board approval was obtained for this study. A retrospective chart review was performed including all patients with orthopedic injuries at our Level I trauma center between July 19, 2021 and July 19, 2022. These dates include 6 months prior to and after the major e-scooter operators ceased use in Miami. SPSS statistical software version 28.0.0 (SPSS, IBM, Armonk, NY) was utilized for all statistical analysis. RESULTS There were 2558 patients in the prenotice cohort, and 2492 patients in the postnotice cohort. After the notice, there was a significant decrease in the number of patients that presented to our institution due to injuries caused by e-scooters (2.8% vs. 1.8% patients; p = 0.021). Patients with injuries caused by e-scooters had a significantly lower age (38 vs. 42, respectively; p = 0.034) and were more likely to be male (79.3% vs. 67.4% male, respectively; p = 0.007) than patients with other orthopedic injuries. CONCLUSION This study demonstrates that the 2022 notice revoking the major mobile application operators from the City of Miami resulted in a significant decrease in the number of orthopedic cases due to e-scooter-related injury at the corresponding Level I trauma center.
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Affiliation(s)
- Moses Markowitz
- Department of Orthopedics, University of Miami, Miller School of Medicine, Miami, Florida
| | - Eric Kholodovsky
- Department of Orthopedics, University of Miami, Miller School of Medicine, Miami, Florida
| | - David Constantinescu
- Department of Orthopedics, University of Miami, Miller School of Medicine, Miami, Florida
| | - Jonathan Weinerman
- Department of Orthopedics, University of Miami, Miller School of Medicine, Miami, Florida
| | - Giselle Hernandez
- Department of Orthopedics, University of Miami, Miller School of Medicine, Miami, Florida
| | - Seth D Dodds
- Department of Orthopedics, University of Miami, Miller School of Medicine, Miami, Florida
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9
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Rashid J, Wu S, Abdelrahman A, McMillan K. Maxillofacial trauma caused by e-scooters: a retrospective review prior to the extension of the UK scheme. Br J Oral Maxillofac Surg 2024; 62:157-163. [PMID: 38238115 DOI: 10.1016/j.bjoms.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/12/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
The nationwide extension of the electric scooter (e-scooter) scheme, which began in 2020, aimed to alleviate public transport congestion, to reduce pollution and peak-time road traffic. This retrospective study evaluates the range of e-scooter-related maxillofacial trauma before the recent scheme extension and compares the findings with existing literature on this topic. The Queen Elizabeth Hospital Birmingham, United Kingdom (UK) operates as a Level 1 Regional Major Trauma Centre and serves a population of four million. All patient records between September 2021 to September 2022 were analysed to establish the types of e-scooter-related maxillofacial trauma sustained. A Pearson's chi-squared test was used to assess for significant associations between variables recorded. Falls accounted for the majority of injuries (44.3%), and soft tissue lacerations were the most common maxillofacial injury (38%). Statistically significant results were measured in the following variables: gender and intoxication status (p = 0.007), helmet status and injuries sustained in maxillofacial and non-maxillofacial regions (p = 0.043), mechanism of injury and injuries sustained in both the maxillofacial and non-maxillofacial regions (p = 0.045). E-scooters are an emerging concern within the UK. Further studies across the UK are required to assess the frequency of e-scooter-related injuries. Such data may prove useful in determining the government's decision on e-scooter use on UK roads.
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Affiliation(s)
- J Rashid
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
| | - S Wu
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
| | - A Abdelrahman
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
| | - K McMillan
- Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham B15 2GW, United Kingdom.
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Siebert FW, Riis C, Janstrup KH, Lin H, Hüttel FB. Computer vision-based helmet use registration for e-scooter riders - The impact of the mandatory helmet law in Copenhagen. JOURNAL OF SAFETY RESEARCH 2023; 87:257-265. [PMID: 38081699 DOI: 10.1016/j.jsr.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/13/2023] [Accepted: 09/21/2023] [Indexed: 12/18/2023]
Abstract
PROBLEM E-scooters are a new form of mobility used more frequently in urban environments worldwide. As there is evidence of an increased risk of head injuries, helmets are recommended and (less frequently) legislated. Denmark has enacted mandatory e-scooter helmet use legislation from January 1, 2022. So far, it is unclear how this newly implemented law influenced helmet use of e-scooter riders in Denmark immediately after its implementation. METHOD In this observational study, we register and compare e-scooter helmet use before the mandatory helmet use legislation (December 2021) and after (February 2022). As observational survey data collection in the field can be highly time-consuming, we conducted a video-based observation survey. We trained and applied a computer vision algorithm to automatically register e-scooter helmet use in the video data. RESULTS The trained algorithm produces accurate helmet use data, which does not differ significantly from human-registered helmet use. In applying the algorithm to video data collected in December 2021 and February 2022, we register an overall e-scooter helmet use of 4.4% in n = 1054 riders. Splitting the observation between the time before and after the implementation of the helmet use law reveals a significant increase in helmet use from 1.80% to 5.56%. DISCUSSION In this study, we successfully train and apply an object detection algorithm to register accurate helmet use data in videos collected in Copenhagen, Denmark. Using this algorithm, we find a significant impact of a new mandatory e-scooter helmet use law on e-scooter riders' helmet use behavior. Limitations of the study as well as future research needs, are discussed. PRACTICAL APPLICATIONS Computer vision algorithms can be used for accurate e-scooter helmet assessments. Implementing a mandatory helmet use law can increase helmet use of e-scooters at specific observation sites.
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Affiliation(s)
- Felix Wilhelm Siebert
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark.
| | - Christoffer Riis
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark
| | - Kira Hyldekær Janstrup
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark
| | - Hanhe Lin
- School of Science and Engineering, University of Dundee, Nethergate, Dundee DD1 4HN, Scotland, United Kingdom
| | - Frederik Boe Hüttel
- DTU Management, Technical University of Denmark, Bygningstorvet 116, Kgs. Lyngby 2800, Denmark
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11
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Kayaalp ME, Kilic NC, Kandemir I, Bayhan M, Eceviz E. Electric scooter-associated orthopedic injuries cause long absence from work, regret and are emerging as a major cause of hip fractures in young individuals: a comprehensive study from a regional trauma center in a densely populated urban setting. Eur J Trauma Emerg Surg 2023; 49:2505-2513. [PMID: 37410134 DOI: 10.1007/s00068-023-02322-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE This study aimed to give a full spectrum of orthopedic injuries associated with electric scooter (e-scooter) use and analyze related factors, report on follow-up data from the patient's perspective and make a comparative etiological analysis of young adult hip fractures. METHODS A total of 851 consecutive patients were admitted to the Emergency Department following e-scooter injuries between January 2021 and July 2022, of whom 188 had 214 orthopedic injuries. The demographics, injury, and incident characteristics of these patients were collected. All fractures were classified as per the AO/OTA classification. Two groups were created as operatively or conservatively treated patients and data were comparatively analyzed. Follow-up examination incorporated a survey using binary questions on patients' perspectives. An etiological comparative analysis of hip fractures in young adults admitted to the same center between 2016 and 2022 was conducted. RESULTS The median patient age was 25. Inexperienced drivers constituted 32% of the injured. The protective gear use rate was at 3%. Higher speed (p = 0.014) and age (p = 0.011) were significantly associated with operative treatment. A total of 39% of the operated patients could not return to preinjury physical function, while 74% regretted using an e-scooter. The most common etiological factor for traumatic young hip fractures was fall from a height between 2016 and 2020, whereas it became e-scooter accidents in 2021-2022. CONCLUSION The rate of e-scooter-related operative treatment is high and leaves the patient in regret (84%) and a physically limited condition (39%). A speed limit of ≤ 15 km/h could decrease the rate of operative injuries. The e-scooter was identified as the top etiological factor in the last 2 years for traumatic young hip fractures. LEVEL OF EVIDENCE II, Diagnostic cohort study.
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Affiliation(s)
- Mahmut Enes Kayaalp
- Department of Orthopaedics and Traumatology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, USA.
| | - Nazim Canberk Kilic
- Department of Orthopaedics and Traumatology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim Kandemir
- Department of Orthopaedics and Traumatology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Mazlum Bayhan
- Department of Orthopaedics and Traumatology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Engin Eceviz
- Department of Orthopaedics and Traumatology, Istanbul Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
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12
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Leyendecker J, Hackl M, Leschinger T, Bredow J, Krane F, Eysel P, Müller LP, Harbrecht A. Lessons learned? Increasing injury severity of electric-scooter accidents over a period of one year: a monocentric follow-up study at a level 1 trauma center. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:3643-3648. [PMID: 37268872 PMCID: PMC10238235 DOI: 10.1007/s00590-023-03583-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE After major COVID-19 lockdown measures were suspended in 2021, E-scooter mobility regrew rapidly. In the meantime, multiple studies were published on the potential risks for e-scooter drivers and the necessity for wearing protective equipment. But did the drivers learn their lessons? METHODS We observed data of E-scooter-related accidents admitted to the emergency department of a level 1 German trauma center in the year 2021 and compared the data with our previous report (July 2019-July 2020). RESULTS N = 97 E-scooter-related accidents were included, marking a 50% increase when compared to the previous observation. Most patients were young adults (28.18 ± 1.13 years) with a notable shift towards a male population (25 vs. 63, p = 0.007). While the injury pattern remained unchanged, injury severity, reflected by a significant increase in shock room treatments (p = 0.005), hospital admissions (p = 0.45), and ICU admissions (p = 0.028), increased. Lastly, we report a higher injury severity of patients driving under the influence of alcohol, expressed by significant differences in hospital admissions, shock room treatments, ICU admissions, intracerebral bleeding (p < 0.0001), and injuries requiring surgery (p = 0.0017). CONCLUSION The increase in injury severity and especially the substantial number of accidents due to driving under the influence of alcohol, are alarming for both trauma- and neurosurgeons. As the controversy surrounding the general use of E-scooters will continue, we urge representatives to intensify their efforts regarding prevention campaigns focusing on the potential dangers of E-scooters, especially when driving under the influence of alcohol.
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Affiliation(s)
- Jannik Leyendecker
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
| | - Michael Hackl
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tim Leschinger
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan Bredow
- Department of Orthopedics and Trauma Surgery, Krankenhaus Porz Am Rhein, University of Cologne, Cologne, Germany
| | - Felix Krane
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Peer Eysel
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lars P Müller
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Andreas Harbrecht
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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13
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Chontos R, Grindle D, Untaroiu A, Doerzaph Z, Untaroiu C. A Numerical Investigation of Rider Injury Risks During Falls Caused by E-Scooter-Stopper Impacts. J Biomech Eng 2023; 145:101006. [PMID: 37382609 DOI: 10.1115/1.4062847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
Within the past decade, injuries caused by electric scooter (e-scooter) crashes have significantly increased. A primary cause is front wheel collisions with a vertical surface such as a curb or object, generically referred to as a "stopper." In this study, various e-scooter-stopper crashes were simulated numerically across different impact speeds, approach angles, and stopper heights to characterize the influence of crash type on rider injury risk during falls. A finite element (FE) model of a standing Hybrid III anthropomorphic test device was used as the rider model after being calibrated against certification test data. Additionally, an FE model of an e-scooter was developed based on reconstructed scooter geometry. Forty-five FE simulations were run to investigate various e-scooter crash scenarios. Test parameters included impact speed (from 3.2 m/s to 11.16 m/s), approach angle (30 deg to 90 deg), and stopper height (52 mm, 101 mm, and 152 mm). Additionally, the perpendicular (90 deg) impact scenarios were run twice: once with Hybrid-III arm activation to mimic a rider attempting to break a fall with their hands and once without this condition. Overall, the risks of serious injury to the rider varied greatly; however, roughly half the impact scenarios indicated serious risk to the rider. This was expected, as the speeds tested were in the upper 25th percentile of reported scooter speeds. The angle of approach was found to have the greatest effect on injury risk to the rider, and was shown to be positively correlated with injury risk. Smaller approach angles were shown to cause the rider to land on their side, while larger approach angles caused the rider to land on their head and chest. Additionally, arm bracing was shown to reduce the risk of serious injury in two thirds of the impact scenarios.
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Affiliation(s)
- Rafael Chontos
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24060
| | - Daniel Grindle
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24060
| | | | - Zachary Doerzaph
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24060; Virginia Tech Transportation Institute, Virginia Tech, Blacksburg, VA 24060
| | - Costin Untaroiu
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24060
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14
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Kültür Y, Nuri Tütüncü M, Ulutaş S. Using e-scooters: An easy way to get home or a nightmare? An orthopedic perspective on e-scooter accidents. ULUS TRAVMA ACIL CER 2023; 29:1158-1166. [PMID: 37791439 PMCID: PMC10644078 DOI: 10.14744/tjtes.2023.35848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/02/2023] [Accepted: 08/02/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND The percentage of e-scooter use quickly escalated in our community due to its convenience, low cost, and eases of use. The number of accidents causing high-energy traumas has also increased. This study aims to describe the demographic char-acteristics and fracture patterns of patients admitted to the emergency department following an e-scooter accident and to identify common, correctable factors that increased the likelihood of accidents. METHODS Between January 2022 and August 2022, 43 patients (20 females and 23 males) who were admitted to the emergency department after an e-scooter accident and developed extremity fractures were included. The patients were divided into 2 groups those treated surgically and conservatively. Parameters such as the time of the accident, education level of the user, alcohol use, e-scooter malfunction, and compliance with traffic rules were evaluated. RESULTS Accidents that led to treatment by surgery mostly occurred between 11 pm and 7 am. Surgically treated patients were mostly high school graduates. Alcohol use and recreational scooter use rates were statistically higher in the operated patients when compared to patients who were treated conservatively. The number of patients who reported a malfunction in the e-scooter was significantly lower in the operated group than in the conservative group. The rates of accidents due to non-compliance with traffic laws, driving at full speed of the e-scooter, use on the driveway, and presence of wet ground at the time of the accident were higher in the surgically treated patient group. Surgically treated patients also had a higher rate of being 1st time e-scooter users. CONCLUSION Although governments have introduced many regulations regarding e-scooter use, the current situation seems insufficient in solving the problem. E-scooter users should be further educated about the associated risks. Authorities should tighten their supervision of scooter rental companies and drivers. Nighttime usage conditions should be reviewed, and the use of alcohol should be controlled. The use of helmets should be mandatory. If such regulations are tightened, accident rates can be reduced or high-energy impacts from existing accidents can be avoided. The results suggest that experienced, slow, non-alcoholic, and rule-abiding drivers require less operative treatment. This article will hopefully raise awareness and improve e-scooter regulations.
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Affiliation(s)
- Yiğit Kültür
- Department of Orthopedics and Traumatology, Yeni Yuzyil University, Gaziosmanpasa Hospital, İstanbul-Türkiye
| | - Mehmed Nuri Tütüncü
- Department of Orthopedics and Traumatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul-Türkiye
| | - Suat Ulutaş
- Department of Orthopedics and Traumatology, Taksim Training and Research Hospital, İstanbul-Türkiye
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Cittadini F, Aulino G, Petrucci M, Valentini S, Covino M. Electric scooter-related accidents: a possible protective effect of helmet use on the head injury severity. Forensic Sci Med Pathol 2023; 19:319-324. [PMID: 36331707 PMCID: PMC9638347 DOI: 10.1007/s12024-022-00546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
Despite electric scooter use has proliferated in Italy since 2019, actionable data regarding injury incidence and patterns associated with electric scooter accidents are limited. This study aims at analyzing the rate, clinical, and demographic features of electric scooter accidents accessed to the Emergency Department (ED) of Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). This retrospective study included all patients older than 18 years riding an electric scooter in the ED from June 2019 to April 2022. Personal data, injury circumstances, helmet use, and health data were collected. Abbreviated Injury Scale (AIS) codes of all diagnoses were recorded, and the Injury Severity Score (ISS) was calculated for each patient. The analysis includes 92 patients admitted to the ED due to an e-scooter accident during the study period, with an increase in years. Thirty-two patients presented bone fractures especially concerning the extremities and the face districts. The median Injury Severity Score in the study cohort was 3, with the highest AIS represented by AIS Pelvic-Extremity and AIS External. Moreover, statistical significance was found between AIS Head-Neck and severity of trauma. E-scooters have become a familiar sight in cities worldwide recently, with many new companies renting them for use. But their arrival has also brought new safety concerns. Although most injuries reported are minor, the meager rate of helmet use is critical. Implementing compulsory helmet use for electric scooters for all ages could be a protective factor for being patient with head trauma on urban streets.
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Affiliation(s)
- Francesca Cittadini
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito, 00168, Rome, Italy
| | - Giovanni Aulino
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito, 00168, Rome, Italy.
| | - Martina Petrucci
- Emergency Medicine Department, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore Di Roma, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Silvia Valentini
- Department of Health Surveillance and Bioethics, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito, 00168, Rome, Italy
| | - Marcello Covino
- Emergency Medicine Department, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Università Cattolica del Sacro Cuore Di Roma, Largo A. Gemelli 8, 00168, Rome, Italy
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Kim SJ, Lee DW. Epidemiology of Fractures Following Electric Scooter Injury. Indian J Orthop 2023; 57:818-826. [PMID: 37214358 PMCID: PMC10192486 DOI: 10.1007/s43465-023-00862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/27/2023] [Indexed: 05/24/2023]
Abstract
Background The incidence of injuries associated with the use of electric scooter (e-scooter) has consistently increased since the launch of the first shared e-scooter systems in late 2017. The aim with this review was to investigate the epidemiological characteristics of fractures related to e-scooter accidents. Methods A systematic review of the all published papers was conducted regarding epidemiologic characteristics of traumatic fractures following e-scooter-related injuries. Multiple databases of PubMed, Web of Science, EMBASE, and Cochrane library were searched and relevant clinical studies reporting incidence for traumatic fractures from e-scooter-related injuries were included. All other types of studies and those including patients with non-orthopedic injuries were excluded. The Methodological Index for Non-randomized Studies (MINORS) was used to assess the quality of the included studies. The characteristics of patients were analyzed by the mean and the standard deviation for continuous variables. Results Eleven published studies (6579 patients) were identified which have been reported from Nov, 2019 to Sep, 2021. Periods of research in each study were different from May, 2017 to July, 2020. In the majority of cases, the mechanism of injury was a fall from the scooter (84.8%), which was followed by e-scooter motor vehicle accident (7.4%) and collision (5.5%). Regarding the fractures, upper limb injuries were the most prevalent (65%) and radial fracture was the most common fracture type of the upper limb (28.2%). Lower limb fractures were recorded in 475 (25.3%) patients, the most common being tibial fractures (8.4%). Conclusions As e-scooter market continues to considerably rise, the incidence of major orthopedic traumas is also likely to increase. Despite potential selection and reporting biases, our systematic review suggested up-to-date guidelines for the epidemiology of fractures following e-scooter injury. According to the results found in the present study, we believe that it is reasonable to mandate helmet use and the obligation to wear other types of safety equipment such as elbow and knee pads should be discussed.
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Affiliation(s)
- Seung-Ju Kim
- Department of Orthopaedics, Hanil General Hospital, 308 Uicheon-Ro, Dobong-Gu, Seoul, 132-703 Korea
| | - Dong-Woo Lee
- Department of Orthopaedics, Hanil General Hospital, 308 Uicheon-Ro, Dobong-Gu, Seoul, 132-703 Korea
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Kowalczewska J, Rzepczyk S, Okła M, Nijakowski K, Słowik Ł, Makuch A, Hryniewicz O, Krasnoborska J, Żaba C, Osmola K. Characteristics of E-Scooter-Related Maxillofacial Injuries over 2019-2022-Retrospective Study from Poznan, Poland. J Clin Med 2023; 12:jcm12113690. [PMID: 37297885 DOI: 10.3390/jcm12113690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Recently, there has been a considerable rise in the popularity and use of electric scooters. Because of this, the number of accidents involving them has also risen. Head and neck injuries are the most common. The aim of the study was to determine the most frequent craniofacial injuries resulting from accidents involving electric scooters, and to identify the risk factors directly related to their placement and severity. The study carried out a retrospective analysis of the medical records of patients of the Clinic of Maxillofacial Surgery over 2019-2022, in terms of craniofacial injuries suffered as a result of e-scooter-related accidents. In the study population (31 cases), of which 61.3% were men, the median age was 27 years. At the time of the accident, 32.3% patients were under the influence of alcohol. Accidents were most common in the 21-30 age group; more often than not, they occurred during warm months and on weekends. The study identified a total of 40 fractures in the patients. The most common craniofacial injuries were mandibular fractures (37.5%), zygomatic-orbital fractures (20%) and frontal bone fractures (10%). A multidimensional correspondence analysis was also performed, which showed that at an age of under 30, alcohol consumption and female gender were associated with a higher likelihood of mandibular fracture. Proper education on the risks associated with the use of e-scooters is essential, with particular emphasis on the impact of alcohol on the driver. It is important to develop diagnostic and therapeutic algorithms for doctors, both in ED and in specialised departments.
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Affiliation(s)
- Justyna Kowalczewska
- Department of Neurosurgery and Neurotraumatology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Szymon Rzepczyk
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Maciej Okła
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
| | - Łukasz Słowik
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Aleksandra Makuch
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Oliwia Hryniewicz
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Julia Krasnoborska
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Krzysztof Osmola
- Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
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Cakar M, Karslioglu B, Bayraktar MK, Dedeoglu SS, Imren Y, Keskin A. A new etiological cause for anterior cruciate ligament injury: E-Scooter. Acta Orthop Belg 2023; 89:112-116. [PMID: 37294993 DOI: 10.52628/89.1.10751] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The usage of electric scooters has been popular because it is a cheap and fast transportation method. Its use has increased in recent years because public transportation is less preferred during the covid-19 pandemic and in parallel, the publications reporting e-scooter accidents are increasing. There is no article examining the relationship between e-scooter and anterior cruciate ligament (ACL) injury in current literature. We aim to examine the relationship between e-scooter accidents and ACL injury incidence. Patients over the age of 18 years who applied to our orthopedics outpatient clinic with the diagnosis of ACL injury between January 2019- June 2021 were evaluated. 80 e-scooter accidents resulting with ACL tears were reviewed. The electronic medical records of the patients were reviewed retrospectively. Information about the age, gender, trauma history of the patients, and type of trauma was obtained. Fifty-eight patients had a history of falling while stopping the scooter, and 22 patients had a history of falling after hitting something. Anterior cruciate ligament reconstruction was performed with hamstring tendon grafts in 62(77,5%) of the patients included in the study. 18 (22,5%) patients were followed up with functional physical therapy exercises because they did not want to be operated on. Various bone or soft tissue injuries while using e-scooters have been reported in the literature until now. ACL injury is also seen quite frequently after these traumas, and necessary information and warnings should be given to the users to prevent ACL injuries.
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Sorenson TJ, Rich MD, Deitermann A, Gotlieb R, Garcia N, Barta RJ, Schubert W. Likelihood of Craniofacial Injury and Hospitalization with Alcohol Use While Skateboarding and Scootering. Craniomaxillofac Trauma Reconstr 2023; 16:34-38. [PMID: 36824181 PMCID: PMC9941291 DOI: 10.1177/19433875211069219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Study Design: We designed a cross-sectional epidemiologic study to evaluate the influence of substance use on craniofacial injuries in a population of skateboard and scooter users. Objective: The primary outcome of our study was craniofacial injury. The secondary outcome was hospitalization. Methods: We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2019, to December 31, 2020, in the United States. Patients were included in our study if they were evaluated in the emergency department (ED) for a skateboard- or scooter-related injury. Results: There were over 5396 total patients who presented to a NEISS-participating ED after skateboard- or scooter- related trauma during the study period. There were 1136 patients with a craniofacial injury (primary endpoint), and patients under the influence of alcohol or drugs had greater odds of experiencing a craniofacial injury than those not under the influence (odds ratio [OR]: 4.16, 95% confidence interval [CI]: 3.24-5.32, P < .0001). Four hundred-thirty patients were hospitalized (secondary endpoint), and patients under the influence had greater odds of being hospitalized than those not under the influence (OR: 2.83, 95% CI: 2.04-3.91, P < .0001). Conclusions: Alcohol and drug use while skateboarding or scootering drastically increases the likelihood of craniofacial injury and subsequent hospitalization and should be avoided whenever possible. The importance of wearing a helmet while operating these devices cannot be overstated.
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Affiliation(s)
| | - Matthew D. Rich
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | - Rachael Gotlieb
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Nicholas Garcia
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Ruth J. Barta
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery, Regions Hospital, Saint Paul, MN, USA
| | - Warren Schubert
- Division of Plastic Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery, Regions Hospital, Saint Paul, MN, USA
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20
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Bracher AI, Klingler S, Koba S, Jakob DA, Exadaktylos A, Klukowska-Rötzler J, Burkhard JP. Trauma Characteristics Associated with E-Scooter Accidents in Switzerland-A Case Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4233. [PMID: 36901244 PMCID: PMC10002011 DOI: 10.3390/ijerph20054233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
E-scooters have gained popularity worldwide in the last few years. Due to the increase in users, more accidents related to e-scooters can be observed. The present study aimed to analyse epidemiological data, characteristics, and severity of injuries in patients admitted to a Level I trauma centre in Switzerland (Inselspital Bern, University Hospital Bern) after accidents associated with e-scooters. This retrospective case series evaluated 23 patients who presented to the University Hospital of Bern between 1 of May 2019 and 31 of October 2021 after an e-scooter accident. Data were collected on patient demographics, time and cause of the accident, speed, alcohol consumption, helmet use, type and localisation of injury, number of injuries per patient, and outcome. Men were most frequently affected (61.9%). The mean age was 35.8 (STD 14.8) years. Slightly more than half (52.2%) of all accidents were self-inflicted. Most accidents were reported during the night (7 p.m. to 7 a.m., 60.9%) and in summer (43.5%). Alcohol consumption was reported in 43.5% of cases, with a mean blood alcohol level of 1.4 g/l. Most injuries were observed in the face (25.3%) and head/neck area (20.25%). Skin abrasions (56.5%) and traumatic brain injury (43.5%) were the most common types of traumata in terms of total number of patients. Only in one case it was reported that a protective helmet had been worn. Five patients required hospitalisation and four patients underwent surgery. Three patients underwent emergency orthopaedic surgery, and one patient underwent emergency neurosurgery. E-scooter accidents result in a significant number of facial and head/neck injuries. E-scooter riders would potentially benefit from a helmet to protect them in the event of an accident. Additionally, the results of this study indicate that a significant number of e-scooter accidents in Switzerland occurred under the influence of alcohol. Prevention campaigns to raise awareness of the risks of driving e-scooters under the influence of alcohol could help prevent future accidents.
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Affiliation(s)
- Ava Insa Bracher
- Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Samuel Klingler
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Sabine Koba
- Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Dominik Andreas Jakob
- Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Aristomenis Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Jolanta Klukowska-Rötzler
- Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - John-Patrik Burkhard
- Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
- Cleft and Craniofacial Center Professor J. A. Obwegeser, 8005 Zurich, Switzerland
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21
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McKay W, Kerscher W, Riaz M, Mason A. Neurosurgical Consequences of e-Scooter Use: Strategies to Prevent Neurological Injury. Neurotrauma Rep 2023; 4:218-224. [PMID: 37095857 PMCID: PMC10122265 DOI: 10.1089/neur.2022.0073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Rideshare electric scooter accidents have led to increasing emergency department (ED) visits and neurosurgical consultations. This study categorizes e-scooter-related injuries requiring neurosurgical consultation at a single level 1 trauma center. Patients who required neurosurgical consultation from June 2019 to June 2021 with a positive finding on computed tomography imaging were selected for review of patient and injury characteristics, resulting in a sample size of 50 cases. Average patient age was 36.9 (15-69) years, and 70% were male. Seventy-four percent of patients were under the influence of alcohol and 12% illicit drugs. None (0%) were helmeted. Seventy-eight percent of accidents occurred between 6:00 pm and 6:00 am. Twenty-two percent of patients required surgical intervention by craniotomy/craniectomy, and 4% required intracranial pressure monitor placement. Average intracranial hemorrhage volume was 17.8 cc (trace to 125). Volume of hemorrhage was associated with the need for an intensive care unit (ICU) stay (odds ratio [OR] = 1.01; p = 0.04), need for surgical intervention (OR = 1.007; p = 0.0001), and mortality (1.816; p < 0.001) and trended toward, but did not reach significance for, overall poor outcome (OR = 1.63; p = 0.06). Sixty-two percent of this patient pool required ICU admission. Average length of ICU stay was 3.5 days (0-35), and average length of hospital stay was 8.3 days (0-82). Mortality in this series was 8%. Lower admission Glasgow Coma Scale (OR = 0.974; p < 0.001) and increased volume of hemorrhage (OR = 1.816; p < 0.001) were associated with increased risk of mortality in the linear regression analysis. Electric scooters have become prevalent in most urban centers, and accidents are a potential source of severe intracranial injury requiring extended ICU and hospital stays, surgical intervention, and sometimes resulting in long-term morbidity and/or mortality. Injuries often occur in the evening hours and are often associated with alcohol/drug use and lack of helmet use. Policy changes to help mitigate the risk of these injuries are recommended.
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Affiliation(s)
- William McKay
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
- Address correspondence to: William McKay, MD, Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, 12631 East 17th Avenue, 5001, Aurora, CO 80045, USA.
| | - William Kerscher
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
- Emory University, Denver, Colorado, USA
| | - Muhammad Riaz
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
| | - Alexander Mason
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
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22
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Sritharan R, Blore C, Arya R, McMillan K. E-scooter-related facial injuries: a one-year review following implementation of a citywide trial. Br Dent J 2023; 234:102-105. [PMID: 36707582 PMCID: PMC9880910 DOI: 10.1038/s41415-023-5459-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/26/2022] [Indexed: 01/28/2023]
Abstract
Objective Birmingham City Council commenced electric scooter (e-scooter) trials in September 2020 as part of the wider UK effort to introduce e-scooters as an alternative method of transport. We aimed to review and evaluate maxillofacial injuries in the initial trial period of one year and comment on the safety implications.Method The Queen Elizabeth Hospital is a Level 1 Major Trauma Centre and the hub for maxillofacial services in Birmingham, UK. A single-centre retrospective study captured patients who sustained e-scooter-related facial injuries in the Birmingham e-scooter trial period from September 2020 to September 2021.Results A total of 29 patients were identified as having facial injuries. Of those patients: 59% (n = 17) were men and aged under 30; 43% (n = 18) of all injuries recorded involved hard tissue; and 41% (n = 12) were recorded to be under the influence of alcohol or cannabis. The non-use of helmets was recorded in 34% (n = 10) of patients. Additionally, 20 patients were managed operatively and 100% of patients (n = 12) that were under the influence of drugs or alcohol required operative management.Conclusion With the introduction of these trials, it is shown that facial injuries represent a sizeable proportion of all injuries. E-scooters have significant safety issues. Our study may influence legislation to account for improvements in users' compliance with safety measures and enforcement of those using e-scooters illegally. Legislation regarding the future of e-scooters is expected in the coming year as outlined in the 2022 Queen's Speech.
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Affiliation(s)
- Rajeevan Sritharan
- Junior Specialist Dentist in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2GW, UK.
| | - Christopher Blore
- Speciality Registrar in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Richa Arya
- Dental Core Trainee in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Kevin McMillan
- Consultant in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way, Birmingham, B15 2GW, UK
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Abstract
Aims Due to the recent rapid expansion of scooter sharing companies, there has been a dramatic increase in the number of electric scooter (e-scooter) injuries. Our purpose was to conduct a systematic review to characterize the demographic characteristics, most common injuries, and management of patients injured from electric scooters. Methods We searched PubMed, EMBASE, Scopus, and Web of Science databases using variations of the term “electric scooter”. We excluded studies conducted prior to 2015, studies with a population of less than 50, case reports, and studies not focused on electric scooters. Data were analyzed using t-tests and p-values < 0.05 were considered significant. Results We studied 5,705 patients from 34 studies. The mean age was 33.3 years (SD 3.5), and 58.3% (n = 3,325) were male. The leading mechanism of injury was falling (n = 3,595, 74.4%). Injured patients were more likely to not wear a helmet (n = 2,114; 68.1%; p < 0.001). The most common type of injury incurred was bony injuries (n = 2,761, 39.2%), of which upper limb fractures dominated (n = 1,236, 44.8%). Head and neck injuries composed 22.2% (n = 1,565) of the reported injuries, including traumatic brain injuries (n = 455; 2.5%), lacerations/abrasions/contusions (n = 500; 7.1%), intracerebral brain haemorrhages (n = 131; 1.9%), and concussions (n = 255; 3.2%). Standard radiographs comprised most images (n = 2,153; 57.7%). Most patients were treated and released without admission (n = 2,895; 54.5%), and 17.2% (n = 911) of injured patients required surgery. Qualitative analyses of the cost of injury revealed that any intoxication was associated with higher billing costs. Conclusion The leading injuries from e-scooters are upper limb fractures. Falling was the leading mechanism of injury, and most patients did not wear a helmet. Future research should focus on injury characterization, treatment, and cost. Cite this article: Bone Jt Open 2022;3(9):674–683.
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Affiliation(s)
- Priya Singh
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghana Jami
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph Geller
- Department of Orthopedic Surgery, University of Miami, Miami, Florida, USA
| | - Caroline Granger
- Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA
| | - Lauren Geaney
- Department of Orthopedic Surgery, University of Connecticut, Mansfield, Connecticut, USA
| | - Amiethab Aiyer
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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24
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Kowalczewska J, Rzepczyk S, Żaba C. E-scooters and the City – head to toe injuries. JOURNAL OF MEDICAL SCIENCE 2022. [DOI: 10.20883/medical.e672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In the recent years electric scooters have become much more common. As the number of drivers increased, so did the number of accidents and injuries involving e-scooters. The most common are head and neck injuries, including open wounds of soft tissues, traumatic brain injuries (TBIs), fractures of the skull bones, and intracerebral hemorrhages (ICH). The second most frequent are injuries to both upper and lower limbs. Fractures of the spine and injuries to the chest and abdominal cavity are less common. Many injuries could be avoided by using helmets, not driving e-scooters under the influence of intoxicating substances, and systematizing the rules of using e- scooters among other road traffic users.
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Slow and Steady Wins the Race: A Comparative Analysis of Standing Electric Scooters’ European Regulations Integrated with the Aspect of Forensic Traumatology. SUSTAINABILITY 2022. [DOI: 10.3390/su14106160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fuel-driven cars are widely considered unsustainable and contrary to the new paradigm of smart growth planning. The need to reform transport behavior, policies, and infrastructure is among the priorities in urban policies around the world. Electric vehicles are an emerging technology that could advance sustainability programs. In the past year, there has been a rapid increase in the diffusion of electric scooters in several European cities, but various states have been unprepared for the rapid spread of green micro-mobility from a regulatory point of view. In addition, in parallel with the spread, there have been numerous road collisions involving standing electric scooters. The aim of this study was to obtain a detailed view of this phenomenon. We focused on the current legislation on electric micro-mobility at the European level to study and summarize the different attitudes adopted by various states whose regulations are present on the web. (It was not possible to evaluate the regulations of all European countries because they are not all available on online platforms.) The elements assessed in the various regulation were age limits, speed limits, compulsory use of helmets, administrative penalties, and the obligation to insure the new e-vehicle (standing scooter). In this study, we analyze the state of the art in electric micro-mobility, highlight the current situation’s limits, and propose new strategies to adequately integrate this new smart vehicle into the urban transport network.
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