title: The Vicious Cycle: Pediatric Facial Trauma from Bicycling.
abstract: OBJECTIVE
  Although prevention of head injuries through helmet use is widespread, there has been a paucity of inquiry and publicity regarding the potential for facial injury stemming from cycling. Our objectives included estimating the incidence of emergency department (ED) visits for bicycle-related facial trauma among the pediatric population and detailing injury patterns.
  
  
  METHODS
  Analysis of a nationwide database.
  
  
  METHODS
  The National Electronic Injury Surveillance System, offered by the Consumer Product Safety Commission, was accessed for ED visits related to bicycle-related facial trauma among individuals 21 years old and younger. These data were used to estimate national incidence and examine patient demographics and injury characteristics.
  
  
  RESULTS
  From 2010 to 2014, there were 5420 entries extrapolating to an estimated 178,457 ED visits for pediatric bicycle-related facial trauma. Median age was 8 years, and 71.9% of patients were male. Lacerations (63.1%), abrasions/contusions (27%), and fractures (7%) were most common, with fractures dramatically increasing in prevalence with age. Nasal fractures were the most common fracture type. Injury patterns varied by age.
  
  
  CONCLUSIONS
  Bicycle-related facial trauma is prevalent among the pediatric population, with nearly 180,000 visits to EDs between 2010 and 2014. Soft tissue injuries predominated among all age groups, although fractures increased significantly with age. Knowledge of injury patterns described may be a useful adjunct assisting history, examination, and decision making regarding the use of medical imaging. There is a clear void in inquiry regarding the use of facial protection, reinforcing the need for further study into prevention and efforts to raise public awareness among youth.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA psvider@gmail.com.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Burchhardt
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Priyanka S
authors.initials: PS
authors.lastname: O'Brien
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Mahdi A
authors.initials: MA
authors.lastname: Shkoukani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Giancarlo F
authors.initials: GF
authors.lastname: Zuliani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Folbe
mesh_terms: D000293:Adolescent; D001642:Bicycling / Q000293:injuries*; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005151:Facial Injuries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: bicycle; bicycling; consumer product safety; craniofacial trauma; facial trauma; national electronic injury surveillance system