Bicycle and motorcycle spoke injuries in children as passengers

To determine the spectrum and severity of injuries seen in children passengers, who get their feet entangled in the spokes of bicycle and motorcycle wheels, and to study the mechanism of this injury to find a pattern.

Descriptive and prospective study.

Combined Military Hospital, Quetta, between July 2001 and June 2003.

This study included 92 consecutive patients referred to the Paediatric Surgical Department. According to the severity of injury, the patients were divided into three groups. The parents were asked a detailed history about the exact mechanism of injury, and such situations were analysed.

The average age was 3.9 years. Seventy-one were males and 21 females. A total of 80 children had their injury while riding a bicycle, the rest had their feet entangled in motorcycle spokes. Majority had type I injury. Motorcycle injuries mostly belonged to type III. There were only 2 fractures. Study of the mechanism of injury showed an obvious pattern. Front wheel injury mainly caused inversion, with laceration over dorsum and medial aspect of the foot and medial malleolus. Rear wheel injury mostly caused eversion, with skin damage to the lateral and posterior aspect of foot and ankle, with lateral malleolus at risk.

Bicycle/motorcycle is an important means of transport for the whole family in most of the third world countries. Without proper footrests and unguarded spokes severe injury to the feet of young passengers can occur. By ascertaining in which wheel (front or rear) the foot was entangled, injuries can be predicted, and hence not missed.