title: Mechanisms of injury in competitive off-road bicycling.
abstract: OBJECTIVE
  To describe the mechanisms of injury from crashes during competitive off-road bicycling (mountain biking) and to examine the type, location, and severity of the resulting injuries.
  
  
  METHODS
  We examined and interviewed all bicyclists injured while competing at 7 off-road bicycling events. Information regarding the direction of fall and the presence of a collision or mechanical failure was obtained, and the injury patterns were compared.
  
  
  RESULTS
  There were 97 injured riders, with a mean age of 28.3 years. Most victims were male (74%), and all cyclists wore helmets. Most injuries were minor and involved the extremities (70.5%). Injuries sustained from falling forward over the handlebars occurred more often than from falling to the side (65% vs 25%), tended to lead to injuries that were more severe (mean injury severity score [ISS] = 3.4 vs 1.7, P < .05), and produced more head and neck injuries (56% vs 8%, P < .05). Falls to the side generally led to a lower extremity injury (88% vs 57%, P < .05). Riders who were involved in collisions had injuries that were similar in severity and location to those of riders who had no collision.
  
  
  CONCLUSIONS
  These findings suggest that off-road bicyclists whose mechanism of injury involves falling forward over the handlebars are at risk for more severe injury, especially to the head and neck.
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center, CA 92354, USA. drtkchow@aol.com
authors.forename: Tony K
authors.initials: TK
authors.lastname: Chow
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kronisch
mesh_terms: D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000453:epidemiology / Q000209:etiology; D001265:Athletic Injuries / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D001642:Bicycling / Q000293:injuries* / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D003163:Competitive Behavior; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007869:Leg Injuries / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000453:epidemiology / Q000209:etiology; D013177:Sports; D015599:Trauma Severity Indices