title: Abdominal injuries following bicycle-related blunt abdominal trauma in children.
abstract: BACKGROUND
  The aim of this study was to confirm our clinical impression that intra-abdominal handlebar injuries are progressively increasing in number and severity in the latest years.
  
  
  METHODS
  A retrospective analysis of data concerning 132 patients admitted to our department of pediatric surgery during a 10-year period (between 2003 and 2012), following bicycle-related blunt abdominal trauma, was performed. Patients were divided into two groups: those who fall from their bicycle (N.=43) and those who sustained direct impact from the handlebars (N.=89) and compared.
  
  
  RESULTS
  Number of admitted patients due to bike related injury was increased during a 10-year period. The bikes used by 91.6% of the participants were the high quality BMX, with rigid and strong handlebars. The average age for both groups was 10.3 years (4-16 years). Boys were injured more than girls. Thirty patients from both groups sustained severe abdominal visceral injuries, 25 from the handlebar group and 6 from the fall group (P=0.018). The overall average length of hospital stay was 3.04 days, with 36 cases (27.36%) requiring pediatric intensive care unit (PICU) admission (N.=26 of the handlebar group and N.=10 of the fall group, P=0.024). Eight children sustaining handlebar injuries required abdominal surgery compared to only one case for the fall group (P=0.018), when excluding extra-abdominal procedures.
  
  
  CONCLUSIONS
  Number of pediatric patients admitted due to bike related injury has been gradually increasing. Children who suffer from direct impact of the handlebars are more likely to require abdominal operative intervention and PICU admission than those who fall. Preventive measures are urgently needed in order to defeat this trend.
authors.affiliation: Department of Pediatric Surgery, Assaf Harofeh Medical Centre, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel - klin2@netvision.net.il.
authors.forename: Baruch
authors.initials: B
authors.lastname: Klin
authors.forename: Yigal
authors.initials: Y
authors.lastname: Efrati
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Eran
authors.initials: E
authors.lastname: Kozer
authors.forename: Igor
authors.initials: I
authors.lastname: Jeroukhimov
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abu-Kishk
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D000058:Accidental Falls; D000293:Adolescent; D001642:Bicycling / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology