A CASE SERIES OF BICYCLE HANDLEBAR-RELATED INJURIES IN CHILDREN

Bicycle crashes are a significant source of morbidity and mortality in children. Research efforts have been focused on head injuries and the effectiveness of bicycle helmets. Less understood are bicycling injuries resulting from handlebar impact. In the present study, detailed mechanisms of injury for five children with significant handelbar-related injuries were determined by onsite crash investigations. These investigations were conducted as part of a larger surveillance study, the Injury Circumstance Evaluation (ICE) Study. The ICE Study recruits pediatric patients less than 18 years of age who were transported to The Children's Hospital of Philadelphia and treated for injuries sustained as a bicyclist, pedestrian or motor vehicle occupant. From the 66 cases of injured bicyclists with MAIS >= 2 in the ICE Study, 11 involved handlebar-related injuries. None of the bicycle incidents involved moving motor vehicles. Rather, the incidents involved bicycle mechanical failure, rider loss of balance or riding over uneven road surfaces all of which resulted in rider loss of bicycle control and subsequent truncal impact with the handlebar. Four of the bicycles involved were stunt bicycles and the other was self-assembled with parts from a variety of bicycles. Details of the impact mechanisms, bicycle and handlebar designs, and injuries sustained are documented. The minor incidents that resulted in these potentially life-threatening injuries indicate the role of the bicycle itself in injury causation.