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

Daniel Weltsch 1 Shay Tenenbaum 1 Jason T. Bariteau 2 Adi Givon 3 Kobi Peleg 3 Ran Thein 1
1Department of Orthopaedic Surgery, Chaim Sheba Medical Center, Israel
2Department of Orthopedics, Emory University School Medicine, USA
3Tel Hashomer, National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Israel

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.