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A growing problem: cycling referrals to the National Centre for Pelvic and Acetabular Fracture Management in Ireland

  • Christopher Fenelon
  • Evelyn P. Murphy
  • Colum Downey
  • Brendan J. O’Daly
  • Michael Leonard
Original Article

Abstract

Background

Popularity in cycling continues to grow. In Ireland, in the last 5 years, 42% more people now use it to travel to work. This has been mirrored by a rise in cycling-related trauma and deaths. The popularity amongst men has led to the term middle-aged men in Lycra (MAMIL) being coined.

Aims

The purpose of our study was to quantify cycling-related pelvic and acetabular fracture referrals in Ireland and determine injury patterns, cost and functional outcomes following these injuries.

Methods

A retrospective cohort study was conducted of all referrals to our institution, the National Centre for Pelvis and Acetabular Fracture Management, in 2016 and 2017. Demographic, mechanism of injury, concomitant trauma and treatment data were analysed. Patients were contacted to assess return to work, sport and quality of life (EQ-5D-3L).

Results

Cycling injury referrals increased by 90% between 2016 and 2017 with a greater number of cycling than motorbike injury referrals. Twenty-nine patients sustained a pelvic and acetabular (PA) injury while cycling. The mean patient age was 51.7 years of which 86.2% were male with 41% suffering a concomitant injury. Fourteen patients (48.3%) required surgery of which 60% have returned to cycling. Mean cost of treatment was €11,757. The median EQVAS was 80.

Conclusions

The rise in popularity of cycling has been mirrored by an increase in PA injuries and deaths. These injuries are associated with significant costs to the patient, hospital and society. Greater investment in safety and awareness is needed to protect this vulnerable group.

Keywords

Acetabular Cost Cycling Fractures Pelvis Trauma 

Notes

Acknowledgements

We would like to thank the orthopaedic and nursing staff of Frank’s Ward in helping maintain the database.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institution and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants in the study.

References

  1. 1.
    Gansslen A, Pohlemann T, Paul C et al (1996) Epidemiology of pelvic ring injuries. Injury27:S-A 27:13–20CrossRefGoogle Scholar
  2. 2.
    Court Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697CrossRefGoogle Scholar
  3. 3.
    Ragnarsson B, Jacobsson B (1992) Epidemiology of pelvic ring injuries in a Swedish county. Acta Orthop Scand 63(3):297–300CrossRefGoogle Scholar
  4. 4.
    Prieto-alhambra D, Aviles FF, Judge A et al (2012) Burden of pelvis fracture: a population-based study of incidence, hospitalisation and mortality. Osteoporos Int 23(12):2797–2803CrossRefGoogle Scholar
  5. 5.
    Laird A, Keating JF (2005) Acetabular fractures; a 16-year prospective epidemiological study. J Bone Joint Surg Br 87(7):969–973CrossRefGoogle Scholar
  6. 6.
    Buller L, Lawrie CM, Vilella FE (2015) A growing problem: acetabular fractures in the elderly and the combined hip procedure. Orthop Clin North Am 46(2):212–225CrossRefGoogle Scholar
  7. 7.
    Boudissa M, Francony F, Kerschbaumer G, Ruatti S, Milaire M, Merloz P, Tonetti J (2017) Epidemiology and treatment of acetabular fractures in a level-1 trauma centre: Retrospective study of 414 patients over 10 years. Orthop Traumatol Surg Res 103(3):335–339CrossRefGoogle Scholar
  8. 8.
    Oja P, titze S, Baumen A et al (2011) Health benefits of cycling: a systematic review. Scan J Med Sci Sports 21(4):496–509CrossRefGoogle Scholar
  9. 9.
    Fishman E, Schepers P, Kamphuis CB (2015) Dutch cycling: quantifying the health and related economic benefits. Am J Publin Health 105(8):e13–e15CrossRefGoogle Scholar
  10. 10.
    Cycling UK. Surrey (England). Cycling UK cycling statistics 2018 https://www.cyclinguk.org/resources/cycling-uk-cycling-statistics. Accessed on 6 May 2018
  11. 11.
    Central Statistics Office (CSO) Ireland. Census of population 2016 – profile 6 commuting in Ireland. 2016. http://www.cso.ie/en/csolatestnews/presspages/2017/census2016profile6-commutinginireland/. Accessed on 6 May 2018
  12. 12.
    Oxford University Press. Oxford dictionaries. 2018. https://en.oxforddictionaries.com/definition/mamil. Accessed on 6 May 2018
  13. 13.
    Court-Brown CM, Allan M, Davidson E, McQueen MM (2013) The epidemiology of cycling fractures in adults. Emergency Med 3:139Google Scholar
  14. 14.
    Broe MP, Kelly JC, Groarke PJ, Synnott K, Morris S (2018) Cycling and spinal trauma: a worrying trend in referrals to a national spine centre. Surgeon 16(4):202–206CrossRefGoogle Scholar
  15. 15.
    Road Safety Authority. Mayo (Ireland). Deaths on Irish roads 2018. 2018. http://www.rsa.ie/RSA/Road-Safety/Our-Research/Deaths-injuries-on-Irish-roads/. Accessed on 6 May 2018
  16. 16.
    Road Safety Authority. Mayo (Ireland). Cyclists. 2018. http://www.rsa.ie/RSA/Road-Safety/Campaigns/Current-road-safety-campaigns/Cyclists/. Accessed on 6 May 2018
  17. 17.
    Caulfield B (2014) Re-cycling a city—examining the growth of cycling in Dublin. Transp Res 61:216–226Google Scholar
  18. 18.
    Caulfield B, Leahy J (2011) Learning to cycle again; examining the benefits of providing tax-free loans to purchase new bicycles. Res in Trans Bus Manag 2:42–47Google Scholar
  19. 19.
    Glackin OF, Beale JT (2017) ‘The world is best experienced at 18 mph’. The psychological wellbeing effects of cycling in the countryside: an interpretative phenomenological analysis. Qual Res in Sport, Exercise and Health 10(1):32–46CrossRefGoogle Scholar
  20. 20.
    Rector RS, Rogers R, Ruebel M, Hinton PS (2008) Participation in road cycling vs running is associated with lower bone mineral density in men. Metabolism 57(2):226–232CrossRefGoogle Scholar
  21. 21.
    Scholten AC, Polinder S, Panneman MJ et al (2015) Incidence and cost of bicycle-related traumatic brain injuries in the Netherlands. Accid Anal Prev 81:51–60CrossRefGoogle Scholar
  22. 22.
    Aitken SA, Watson BS, Wood AM, Court-Brown CM (2014) Sports-related fractures in South East Scotland: an analysis of 990 fractures. J Orthop Surg (Hong Kong) 22(3):313–317CrossRefGoogle Scholar
  23. 23.
    Bass A, Lovell ME (1995) Two cases of acetabular fractures sustained during competitive cycling. Br J Sports Med 29(3):205–206CrossRefGoogle Scholar
  24. 24.
    Keel MJ, Bastian JD, Buchler L et al (2010) Surgical dislocation of the hip for a locked traumatic posterior dislocation with associated femoral neck and acetabular fracture. J Bone Joint Surg Br 92(2):442–446CrossRefGoogle Scholar
  25. 25.
    Department of Transport (United Kingdom). Personal injury accident statistics on public roads in Great Britain for 2016. 2017. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/648081/rrcgb2016-01.pdf. Accessed on 6 May 2018
  26. 26.
    Foley J, Cronin J, Gheorghescu A, Chetrit D, Evoy D, Ryan J (2016) Cycling injuries presenting to an Irish emergency department. Ir Med J 109(6):418PubMedGoogle Scholar
  27. 27.
    Giannoudis PV, Grotz MR, Papakositidis C et al (2005) Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br 87(1):2–9CrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  1. 1.National Centre for Pelvic & Acetabular SurgeryTallaght University HospitalDublinIreland

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