title: Elite Motorcycle Racing: Crash Types and Injury Patterns in the MotoGP Class.
abstract: BACKGROUND
  Crashes are a small but regular feature of elite motorcycle racing. These crashes provide a novel opportunity to benchmark and analyze motorcycle crash mechanics, crash types, and associated injuries at high speeds in a cohort of riders who are well protected and in a controlled environment.
  
  
  OBJECTIVE
  The purpose was to benchmark the prevalence of injuries, categorize crash subtypes, and determine associated injury patterns.
  
  
  METHODS
  This was an institutional review board-approved, prospective observational cohort study of MotoGP riders for 1 racing season in 3 venues. Accident type was determined by race-marshal report and visual analysis of race footage for each crash. Accident types were defined as lowside (falling toward the inside of the turn), highside (falling over and toward the outside of the turn), and topside (going over the handlebars of the motorcycle). Specific injuries and hospital admission data were collected using a standardized data collection form. Basic descriptive statistics were performed on all categorical variables. We used the exact binomial test examine the association between accident type and retirement from race, transport to medical building, transport to hospital, and injuries sustained.
  
  
  RESULTS
  Crash prevalence was 9.7 per hundred rider hours. There were 78 crashes: 58 lowsides, 13 highsides, 2 topsides, and 5 indeterminate. In the lowside group (n = 58), 19 (95% confidence interval [CI], 0.21-0.46) riders retired, 0 required emergent transportation to the track facility or to the hospital, and 1 (95% CI, <0.1-0.9) significant injury was noted. In the highside group (n = 13), 10 (95% CI, 0.46-0.95) retired, 9 (95% CI, 0.39-0.91) were transported to the track medical facility, and 3 (95% CI, 0.05-0.54) were admitted to the hospital. In the highside group, there were 7 (95% CI, 0.25-0.81) significant injuries. In the topside group, both riders were retired with 1 hospital admission. Lowside crashes had a lower rate of retirement from race, emergent transport, and significant injuries compared with highside crashes.
  
  
  CONCLUSIONS
  Lowside crashes are lower risk than highside crashes. Most highside crashes are caused by oversteering to prevent an impending lowside crash. Strategies to reduce oversteering to prevent a lowside crash may reduce highside crashes, enhance the safety for riders in MotoGP racing, and be applicable to recreational motorcycle riding.
authors.affiliation: Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, 1400 Barbara Jordan Blvd, Suite 1.114, Austin, TX 78723; Seton Event Medicine Institute (SEMI), University Medical Center Brackenridge, 1400 North IH-35, CEC 2.230, Austin, TX 78701. Electronic address: jbedollamd@austin.utexas.edu.
authors.forename: John
authors.initials: J
authors.lastname: Bedolla
authors.affiliation: Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, 1400 Barbara Jordan Blvd, Suite 1.114, Austin, TX 78723; Seton Event Medicine Institute (SEMI), University Medical Center Brackenridge, 1400 North IH-35, CEC 2.230, Austin, TX 78701.
authors.forename: Jaron
authors.initials: J
authors.lastname: Santelli
authors.affiliation: Seton Event Medicine Institute (SEMI), University Medical Center Brackenridge, 1400 North IH-35, CEC 2.230, Austin, TX 78701; General Surgery, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, 1400 Barbara Jordan Blvd, Suite 1.114, Austin, TX 78723.
authors.forename: John
authors.initials: J
authors.lastname: Sabra
authors.affiliation: Seton Event Medicine Institute (SEMI), University Medical Center Brackenridge, 1400 North IH-35, CEC 2.230, Austin, TX 78701; City of Austin EMS, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, 1400 Barbara Jordan Blvd, Suite 1.114, Austin, TX 78723.
authors.forename: Jose G
authors.initials: JG
authors.lastname: Cabanas
authors.affiliation: Seton Event Medicine Institute (SEMI), University Medical Center Brackenridge, 1400 North IH-35, CEC 2.230, Austin, TX 78701; Emergency Department, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, 1400 Barbara Jordan Blvd, Suite 1.114, Austin, TX 78723.
authors.forename: Chris
authors.initials: C
authors.lastname: Ziebell
authors.affiliation: Seton Event Medicine Institute (SEMI), University Medical Center Brackenridge, 1400 North IH-35, CEC 2.230, Austin, TX 78701; Department of Neurological Surgery, University of Miami, 1611 NW 12th Ave Suite 405, Miami, FL 33136.
authors.forename: Steve
authors.initials: S
authors.lastname: Olvey
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D009049:Motorcycles; D015995:Prevalence; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control