Bicycle riding and oral/maxillofacial trauma in young children

Objectives: To investigate the frequency of oral/maxillofacial injuries in children who have had a bicycle incident and to relate this to the wearing of a protective helmet. Design: Part of a larger prospective study in which self-administered questionnaires were completed by each child with bicycle-related injuries and their parents or caregivers. Setting: Two tertiary-referral children's hospitals (between 1 April 1991 and 30 June 1992) and three general hospitals (between 1 August 1991 and 30 June 1992) in Brisbane. Participants: 813 children aged under 15 years who presented to the accident and emergency departments with bicycle-related injuries. Results: There were 321 children (39.5%) who sustained oral/maxillofacial injuries. Of 1355 injuries, 340 (25.1%) were to the facial region. Of the 153 children admitted to hospital for bicycle-related injuries, 94 (61.4%) had oral/maxillofacial injury as the primary reason for admission (including those with a reduced level of consciousness). Of the 66 children with a reduced level of consciousness, 53 had concomitant facial injuries. The most common oral/maxillofacial injuries were facial abrasions, cuts and lacerations (50.3%); soft tissue injuries to the mouth (30.9%); and dentoalveolar trauma (9.7%). Over half of these children were wearing bicycle helmets. Of the 15 facial fractures (mandibular, nasal, and zygomatico-orbital), 10 were in children wearing helmets. Conclusions: Oral/maxillofacial injuries are frequent among child bicycle riders, even for those who wear Australian Standards-approved bicycle helmets. Bicycle helmets need design modifications (e.g., lightweight chin protectors) to more adequately protect the face and jaw.