title: Bicycle-related injuries in children: disturbing profile of a growing problem.
abstract: BACKGROUND
  We observed a changing pattern of bicycle-related injuries in children, with the focus changing from head trauma to thoracic and abdominal injuries, and a trend to increasingly severe injuries.
  
  
  OBJECTIVE
  To assess the changing injury pattern, and investigate the development of preventive measures to improve safety.
  
  
  METHODS
  Retrospective record review of 142 paediatric patients admitted to our Department of Paediatric Surgery between 1996 and 2005 following bicycle-related injuries. Clinical, laboratory, diagnostic, and therapeutic aspects were analysed. Additional information concerning children's bicycle-related injuries in Israel was obtained from the Gertner Institute (Israel National Center for Trauma and Emergency Medicine Research) and from Beterem (The National Center for Children's Safety & Health, the Safe Kids Israeli Chapter) National Report on Child Injuries in Israel 2006.
  
  
  METHODS
  The nature and severity of injuries were reviewed, and two 5-year periods compared-from 1996 to 2000 (53 children-Group 1), and from 2001 to 2005 (89 children-Group 2).
  
  
  RESULTS
  Head trauma was more common in the Group 1 patients (52.6% vs. 45.2%), but skull fractures and intracranial haemorrhage occurred more frequently in Group 2 (28.5% vs. 16.7%; 21.3% vs. 8.3%, respectively). Injury to the stomach or duodenum, kidneys and liver were all more common in Group 2. Splenic injury occurred with equal frequency in both groups, but more severe injuries were seen in Group 2. More children in Group 2 required intensive care (31% vs. 19.3%).
  
  
  CONCLUSIONS
  There is a changing pattern of bicycle-related injuries in children, with chest and abdominal injuries dominating, and an increasing incidence of more severe injury. These findings are important in decision-making regarding preventive measures.
authors.affiliation: Department of Pediatric Surgery, Assaf Harofeh Medical Center, Zerifin, Israel (affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel).
authors.forename: B
authors.initials: B
authors.lastname: Klin
authors.forename: N
authors.initials: N
authors.lastname: Rosenfeld-Yehoshua
authors.forename: I
authors.initials: I
authors.lastname: Abu-Kishk
authors.forename: Y
authors.initials: Y
authors.lastname: Efrati
authors.forename: E
authors.initials: E
authors.lastname: Kozer
authors.forename: I
authors.initials: I
authors.lastname: Jeroukhimov
authors.forename: G
authors.initials: G
authors.lastname: Eshel
authors.forename: G
authors.initials: G
authors.lastname: Lotan
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000628:therapy; D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D001642:Bicycling / Q000293:injuries*; D002648:Child; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000453:epidemiology / Q000628:therapy