Hard to Handle: Penetrating Bicycle Handlebar Injuries in Children, 2005-2024

Area of Science:

• Pediatric Emergency Medicine
• Injury Prevention
• Trauma Surgery

Background:

• Blunt bicycle handlebar injuries are common, but penetrating injuries from these components are less understood.
• Characterizing penetrating trauma from bicycle handlebars is crucial for effective prevention strategies.

Purpose of the Study:

• To describe the epidemiology, injury patterns, and clinical outcomes of penetrating bicycle handlebar injuries in children.
• To compare outcomes of penetrating versus non-penetrating handlebar injuries.

Main Methods:

• Retrospective cross-sectional study using National Electronic Injury Surveillance System (NEISS) data (2005-2024).
• Identified pediatric patients (≤21 years) with handlebar-related injuries.
• Used diagnosis codes and keyword searches to identify penetrating trauma cases, excluding superficial or ambiguous injuries.

Main Results:

• An estimated 3,078 penetrating handlebar injuries occurred nationally among 12,939 total handlebar injuries.
• Most injuries were puncture wounds (85.8%), with 14.2% involving retained foreign bodies.
• Penetrating injuries were most common in school-age children (5-14 years), affecting the upper leg and abdomen, and were associated with significantly higher hospitalization rates (aOR ~6.30).

Conclusions:

• Penetrating bicycle handlebar injuries are associated with substantially increased hospitalization risk compared to non-penetrating injuries.
• Findings support targeted prevention for school-age children and underscore the need for improved handlebar and brake lever safety designs.