Serious cycling-related fractures in on and off-road accidents: A retrospective analysis in the Australian Capital Territory region

A population-based study of severity of injuries in recreational mountain biking - Discontinued rise following efforts

BACKGROUND

During the recent years, an increase in the number of people practicing recreational mountain biking has been observed. The high-risk sport can cause severe injuries. The most severe injuries involve paralysis and head traumas. These injuries occur to recreational bikers as well as professionals. The purpose of this study is to describe the development in severe injuries and the effort of increasing the safety of mountain biking for recreational bikers.

METHOD

Register-based study with the population of residents in the municipality of Odense who were injured in a mountain bike incident between 2005 and 2021. Data was obtained from the register of the emergency department, where all contacts are registered. The incidence risk for men and women has been calculated, as well as the distribution between age groups and the mechanism of the fall.

RESULTS

A total of 303 severe injuries during the study period illustrates an increase in both the number of injuries and the number of severe injuries. Most of the injuries occur among men aged 40-49. The proportion of severe injuries rises to around 40 % after 2015. The incidence risk was 59 per 10.000 (95 % CI: 53-66) in total, for men 68 per 10.000 (95 % CI: 61-77), and for women 22,6 per 10.000 (95 % CI: 16-31,5).

CONCLUSION

There has been an increase in the number of severe injuries, non-severe injuries, and the proportion of MTB injuries from 2005 to 2020. After 2020, there is a decrease in the number of severe injuries.

Health Service Impacts and Risk Factors for Severe Trauma in Mountain Biking: A Narrative Review

Mountain biking is growing in participation but carries risk for severe injury and burden on health systems. Little is known about the impact of these injuries on emergency medical services, definitive healthcare, and factors contributing to accidents. This review aimed to determine the health service impacts of severe mountain bike trauma and risk factors, with a view to understanding critical gaps and needs. A systematic online search was conducted using the databases PubMed and MEDLINE complete and grey literature relating to mountain bike injury since the databases' inception to July 2023. The results show that although mountain biking has relatively high injury rates that are increasing, the impacts on health services were rarely documented, with some evidence indicating that even small increases in injuries from race events can overwhelm local health services. Severe injuries were more common in downhill disciplines. However, the definitions of what constitutes severe injury were variable. Severe injuries were more common in downhill disciplines, influenced by the rider skill level, demographics, participation in competitive events, trail design, environmental factors, and healthcare availability. Further research in these areas is needed, along with the more consistent reporting of injury severity.

Getting Athletes Back on the Field: Management of Clavicle Fractures and Return to Play

This chapter provides an overview of the prevalence of clavicle fractures in athletes. The evaluation and management of clavicle fractures in athletes is summarized, including surgical considerations, rehabilitation protocols, and return to sport guidelines. In this population, high rates of union are observed, but careful timing of return to sport is paramount to optimize performance and prevent reinjury.

Pelvic ring injuries after road and mountain bike accidents

PURPOSE

The purpose of this study was to compare patients with traumatic pelvic ring injuries sustained in road and mountain bicycling accidents to evaluate for differences in injury types and hospital courses.

METHODS

A retrospective review of 60 patients presenting with pelvic ring injuries after road (n = 46) and mountain (n = 14) bicycling accidents was performed to compare patient/injury characteristics and hospital course.

RESULTS

LC1 injuries were the most common pelvic ring injury (n = 31, 51.7%), 38.7% (n = 12) of which were considered unstable, followed by isolated iliac wing (n = 11, 18.3%), pubic rami (n = 6, 10.0%), and sacral fractures (n = 6, 10.0%). Hospital admission was required for 41 (68.3%) patients. The median hospital LOS was 4 days (IQR 2-9) and 12 (20%) patients received operative treatment. Patients in road versus mountain bicycling accidents were more likely to be older tobacco users and were similar in sex, body mass index, and injury severity score. Road bicycling resulted in more LC1 injuries (58.7% vs 28.6%, p = 0.04), while mountain bicycling resulted in more iliac wing fractures (42.9% vs. 10.9%, p = 0.01). Road cycling injuries required more days in the hospital to clear PT (median difference 2, CI 0-4, p = 0.04) and had longer hospital stays (median difference 2, CI 0-6, p = 0.02) but had no difference in the rate of admission, operative intervention, or discharge to rehabilitation facilities.

CONCLUSION

The majority of pelvic ring injuries from road and mountain bicycling accidents were LC1 injuries that were frequently unstable and often required hospital admission and operative fixation.