Electric Scooter-related Upper Limb Fractures: Analysis of 461 Cases

Purpose:
To perform an analysis of electric scooter (e-scooter)-related upper limb fractures (ULF), the most common e-scooter-related injuries, which have increased dramatically in parallel with the rapid rise in the use of e-scooters and shared e-scooter services in recent years.

Methods:
We retrospectively reviewed the medical charts of e-scooter-related emergency department (ED) visits between January 2017 to January 2020 in a level-I trauma center. All patients with ULF were included in the study, and their data were analyzed for demographics, fracture diagnosis (using the AO/OTA classification), associated injuries, and required surgical treatment.

Results:
This study included 359 patients (51.7% females) with 461 ULF, of which 25 were open fractures (5.4%). The mean age of the cohort was 33 years (standard deviation 10.5). The most common mechanism of injury was rider fall (89.7%). The non-dominant hand was injured in 52.6% of cases, and 31.2% of all fractures were treated operatively. A total of 122 patients (34.0%) sustained more than 1 ipsilateral ULF, and 27 patients (7.5%) had a concomitant contralateral fracture. Radial head fracture was the most common fracture type (n = 123, 26.6%) of which 16 (13.0%) were bilateral. The 5th ray was injured most frequently (n = 33, 47.1%) among the metacarpal and phalange fractures. Most of the non-extremity-associated injuries were head and maxillofacial.

Conclusion:
The most common ULF associated with e-scooters was radial head fracture. Physicians should be alert to and seek associated fractures during initial assessments of e-scooter-related upper limb injuries. Further investigation may be warranted to evaluate the effectiveness of protective measures in reducing the number of injuries.