Epidemiologic studies are often useful when it comes to detecting changes in treatment patterns, identifying disease trends, or understanding the acceptance of a new treatment. A recent study by Shichman et al. helps bridge the span between epidemiologic data and direct clinical care. In the June 16, 2021 issue of JBJS, the authors report on the fracture patterns and the mechanisms and management of injuries related to the use of electric scooters (e-scooters) as documented in their trauma center in Tel-Aviv, Israel. Among their findings:
- A total of 716 fractures were diagnosed in 563 patients during the study period (2017 to 2020); 46.6% of the patients required hospitalization. Surgical treatment was recommended for 225 fractures.
- Of the 492 upper-limb fractures, 89.2% occurred in a rider fall, and of the 210 lower-limb fractures, 15.7% occurred in rider-vehicle collisions. Head concussions and maxillofacial injuries were the most common associated injuries.
- By AO/OTA classification, a radial-head fracture (2R1A, 2R1B, 2R1C) was the most common upper-limb fracture, followed by a distal radial fracture (2R3A, 2R3B, 2R3C). The most common upper-limb procedure was open reduction and internal fixation (ORIF) of the distal part of the radius.
- The most common lower-limb fracture was a tibial plateau fracture (AO/OTA 41A, 41B, 41C). ORIF of the proximal part of the tibia was the most common lower-limb procedure.
The use of e-scooters is expanding in metropolitan areas worldwide, primarily in the form of street rentals. E-scooters can reach speeds in excess of 25 mph, and they require some practice in steering and braking. While an appealing alternative form of transportation for many, they present concerns and challenges related to safety.
The report by Shichman et al. can help trauma centers and orthopaedic surgeons understand the injury patterns they may encounter, and their potential incidence, should an e-scooter service become popular in their city. Such data can support the planning of resources to manage any increase in moderate-velocity vehicular injuries—and help inform conversations on e-scooter safety.
Marc Swiontkowski, MD
JBJS Editor-in-Chief
Co-author Ittai Shichman, MD discusses this study in an “Author Insights” video, found here.
