Craniofacial Injuries Associated With Off-Road Motorbike Use in the United States: A Retrospective NEISS Study

Dirt-bike and trail-bike riding are increasingly popular recreational activities in the United States and are associated with a substantial risk of injury. Craniofacial trauma represents an important but understudied subset of these injuries, particularly given the potential for neurological, functional, and cosmetic consequences. This study aimed to characterize national patterns of craniofacial injuries associated with motorized dirt- and trail-bike accidents using data from the National Electronic Injury Surveillance System. A retrospective analysis was performed using NEISS data from 2015 to 2024. Cases involving 2-wheeled, powered off-road vehicles were identified using product code 5036, and craniofacial injuries were defined using body part codes corresponding to the head, face, eyeball, mouth, neck, and ear. An estimated 116,829 craniofacial injuries associated with off-road motorized bike use were identified during the study period. National injury estimates increased by ∼74.8% from 2015 to 2024. Head injuries accounted for the largest proportion of reportable body-part-specific estimates, followed by facial injuries. Adolescents aged 15 to 19 years accounted for the greatest proportion of injuries. Internal injury was the most frequently reported diagnosis across reportable age groups. Among cases with reportable age-stratified disposition estimates, most patients were treated and released, while a smaller proportion required hospital admission. These findings suggest that dirt and trail motorbike-related craniofacial injuries represent an increasing source of emergency department trauma and support continued surveillance of modifiable risk factors, including protective equipment use and riding conditions.