title: Riding a bicycle: do we need more than a helmet?
abstract: BACKGROUND
  To assess pediatric bicycle-related traumatization in view of types of injuries, incidence and modes of prevention.
  
  
  METHODS
  Retrospective study of pediatric cases admitted to the pediatric intensive care unit of a university-affiliated level II trauma hospital in Israel over 12 consecutive years.
  
  
  RESULTS
  Forty-six patients (three girls, 43 boys) with bicycle-related injuries formed 1% of the total pediatric intensive care unit admissions during the study period. The number of patients with bicycle-related injuries increased significantly during recent years (1996-2001 vs 2002-07: P = 0.003). Most of the cases presented abdominal injuries (54.4%) followed by head (32.6%) and chest (13%) injuries. The median age of patients with abdominal trauma was significantly lower in comparison to patients with other types of injuries (P = 0.002). Abdominal cases required longer hospitalization compared with other patients (P = 0.003). Falling from a bicycle was the main mechanism of injury in abdominal cases (88%) (P = 0.003). Motor vehicle impacts were the main mechanism of injury in patients with head (60%) and chest (66.6%) trauma.
  
  
  CONCLUSIONS
  The incidence of severe bicycle-related injuries requiring intensive care hospitalization is increasing and abdominal trauma forms the main portion of those injuries. We suggest introducing a trunk-protective measure for young bicyclists. Exact information on the mechanism of the injury is important for evaluating the injured patient more accurately.
authors.affiliation: Pediatric Intensive Care Unit Department, Assaf-haRofeh Medical Center, Zerifin, Affiliated to Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abu-Kishk
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Noa
authors.initials: N
authors.lastname: Rosenfeld-Yehoshua
authors.forename: Eran
authors.initials: E
authors.lastname: Kozer
authors.forename: Gad
authors.initials: G
authors.lastname: Lotan
authors.forename: Gideon
authors.initials: G
authors.lastname: Eshel
mesh_terms: D000007:Abdominal Injuries / Q000209:etiology* / Q000473:pathology; D000293:Adolescent; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D008297:Male