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Cheung R, Shukla M, Akers KG, et al. Bicycle handlebar injuries - a systematic review of pediatric chest and abdominal injuries. Am J Emerg Med. 2021;51:13-21doi: 10.1016/j.ajem.2021.09.043.
Cheung, R., Shukla, M., Akers, K. G., Farooqi, A., & Sethuraman, U. (2021). Bicycle handlebar injuries - a systematic review of pediatric chest and abdominal injuries. The American journal of emergency medicine, 5113-21. https://doi.org/10.1016/j.ajem.2021.09.043
Cheung, Roxanne, et al. "Bicycle handlebar injuries - a systematic review of pediatric chest and abdominal injuries." The American journal of emergency medicine vol. 51 (2021): 13-21. doi: https://doi.org/10.1016/j.ajem.2021.09.043
Cheung R, Shukla M, Akers KG, Farooqi A, Sethuraman U. Bicycle handlebar injuries - a systematic review of pediatric chest and abdominal injuries. Am J Emerg Med. 2021 Sep 28;51:13-21. doi: 10.1016/j.ajem.2021.09.043. Epub 2021 Sep 28. PMID: 34649007.
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Am J Emerg Med. 2021 Sep 28;51:13-21. doi: 10.1016/j.ajem.2021.09.043. Epub 2021 Sep 28.

Bicycle handlebar injuries - a systematic review of pediatric chest and abdominal injuries.

The American journal of emergency medicine

Roxanne Cheung, Meghna Shukla, Katherine G Akers, Ahmad Farooqi, Usha Sethuraman

Affiliations

  1. Division of Pediatric Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, USA. Electronic address: [email protected].
  2. Division of Pediatric Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, USA; Wayne State University, 42 W Warren St, Detroit, MI, USA. Electronic address: [email protected].
  3. Shiffman Medical Library, Wayne State University, 4325 Brush St, Detroit, MI 48201, USA. Electronic address: [email protected].
  4. Central Michigan University, 2520 S. University Park Dr., Bldg D, Mt Pleasant, MI 48859, USA. Electronic address: [email protected].
  5. Division of Pediatric Emergency Medicine, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, USA; Central Michigan University, 2520 S. University Park Dr., Bldg D, Mt Pleasant, MI 48859, USA. Electronic address: [email protected].

PMID: 34649007 DOI: 10.1016/j.ajem.2021.09.043

Abstract

OBJECTIVE: The severity of handlebar injuries can be overlooked due to subtle signs and wide range of associated internal injuries. Our objective was to describe thoracoabdominal injuries due to bicycle handlebars and their outcomes in children.

METHODS: Articles that reported thoracoabdominal injuries were identified from database conception to March 3, 2019 using PubMed, EMBASE, Cochrane Library, CINHAHL Complete, Web of Science and Scopus. A systematic review of studies of thoracoabdominal handlebar injuries in children ≤21 years on human-powered bicycles in English was performed. Information on demographics, clinical features, injuries, interventions and outcomes was noted.

RESULTS: A total of 138 articles were identified from 1952 to 2019. There were 1072 children (males, 85.1%) and 1255 thoracoabdominal injuries. Mean age was 9.7 ± 3.3 years old. Common clinical features included abdominal pain and guarding, vomiting, fever and a handlebar imprint. The liver was the most frequently injured organ. Surgery was performed in 338 children with a mean age of 10.0 ± 3.3 years. Twenty-seven children (2.5%) were discharged and returned due to worsening symptoms, of whom 23 (85.2%) required surgery. Thirty-one children (2.9%) transferred to a higher level of care due to injury severity. Two deaths were reported.

CONCLUSION: Bicycle handlebars can cause significant thoracoabdominal injuries. Presence of abdominal pain, vomiting, fever or a circular imprint on the chest or abdomen should prompt further workup. Future studies on diagnostic modalities and best practices are needed to lower the chance of missed injuries.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: Abdominal injuries; Bicycling; Pediatrics; Thoracic injuries

Conflict of interest statement

Declaration of Competing Interest None.

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