Fatbike crashes and severity in a level II trauma center: a 3-month observational study

Fatbikes are rapidly gaining popularity, but data on the severity and characteristics of fatbike-related injuries are lacking. This study compares fatbike-related crashes with those involving city bikes, e-bikes and road bikes.

This is a retrospective single-center study conducted at a Dutch level II trauma center. Between July and September 2024, all Emergency Department visits due to bicycle crashes were included. The primary outcome was the Injury Severity Score (ISS), with secondary outcomes including demographic characteristics, specific injuries, helmet use and the mechanism of the crash.

Of the 468 patients, 24 (5%) were involved in a fatbike crash. They were younger, less likely to wear a helmet (0% vs. 11%; p = 0.028) and more frequently involved in a multi-vehicle crash (54% vs. 26%; p = 0.008). The median ISS was similar between groups (4.0).

Despite the small proportion of total bicycle crashes, fatbike riders constitute a vulnerable group due to their young age, lack of helmet use and higher involvement in multi-vehicle crashes.