Epidemiological Profile of Orthopaedic Injuries Among Electric Bicycle Users In Israel – A Rising Problem

Introduction: The use of electric bicycles (E-bike) has dramatically increased. E-bikes offer convenient, environmental friendly, and less expensive alternative to other forms of transport. However, E-bikes are also a public health challenge in terms of safety. This study is the first to specifically investigate the E-bike related orthopaedic injuries, based on a national trauma registry.

Methods: Data from a National Trauma Registry were reviewed for patients hospitalized following E-bike related injuries. Between 2014 to 2015, a total of 549 patients were reviewed. Data were analyzed according to epidemiology, type of injury, associated injuries and severity, injury mechanism and treatment in the operating room.

Results: A total of 360 (65%) patients sustained orthopaedic injuries, out of them 230 (63.8%) sustained limb or axial skeleton fractures. Lower extremity fractures were more prevalent than upper extremity fractures (p <0.001). The tibia was the most fractured bone (19.17%). Patients over the age of 50 years were at the highest risk for spine (20.45%, p=0.0001), pelvis (15.91%, p=0.0001) and femoral neck (15.91%, p=0.0172) fractures. About 42% of patients sustained associated injuries, with head/neck/face injuries being the most prevalent. About 1 out of 10 patients with fractures sustained a chest or abdominal injury as well. A collision between E-bike and a motorized vehicle was the mechanism of injury in 35% of cases. In this mechanism of injury, patients had 1.7 times the risk for associated injuries (p<0.0001) and the risk for major trauma (ISS score ≥16) was more than the double (p=0.03). One third of patients with orthopaedic injuries required treatment in the operating room. Treatment varied depending on the type of fracture.

Conclusions: This study provides unique information on epidemiological characteristics of injuries, pertinent both to medical care providers, as well as to health policy-makers allocating resources and formulating prevention strategies.