This single-site study compares orthopaedic injuries from e-scooters with those from other micro-mobility transport vehicles, such as bicycles and e-bikes.
This retrospective, observational study assessed the impact of micro-mobility transport vehicle injuries on the orthopaedic unit at the Royal Melbourne Hospital, a major metropolitan hospital and level 1 trauma centre, from 01/01/23 to 31/12/23. Data were collected from the electronic medical records of patients referred from the Emergency Department. Key outcomes included rider demographics, incident characteristics, safety risk factors, injury types, and healthcare utilisation, including surgery.
Over 8,000 referrals were made to the orthopaedic unit in twelve months; 390 were linked to micro-mobility vehicles: 261 bicycle riders (67%), 90 e-scooter riders (23%), 31 e-bike riders (8%), and 8 pedestrians (2%).
The average patient age was 40 years and 70% were male. Substance misuse was documented for 18 (11%) bicycle and 22 (24%) e-scooter riders. Half of cyclists (49% of bicycle riders and 52% of e-bike riders) and one third (31%) of e-scooter riders wore helmets. Cyclists were most often injured in the morning (6 AM to noon) while e-scooter injuries were most common in the afternoon (12 PM to 6 PM). Three pedestrians were injured by bicycles, and five by e-scooters.
Single bone fracture was the most common injury (bicycle 59%, e-scooter 68%, e-bike 48%, pedestrian 88%). Across all groups, injuries to the upper limb were most common (bicycle 67%, e-bike 65%, e-scooter 63%, pedestrian 63%). Surgery was required in one third of cases (36% of cyclists, 19% of e-bike riders, 33% of e-scooters riders, and 25% of pedestrians).
More than two thirds of micro-mobility vehicle user injuries were to cyclists, which is triple the rate of e-scooter riders. Injury severity and management patterns were similar across all groups. A limitation of the study is that head and facial injuries, which are not routinely seen by the orthopaedic team, were not included. Additionally, data collection in this audit was manual and likely under-reported.
Future work would include all injuries, cases from other hospitals and evaluate healthcare costs related to micro-mobility accidents.
This data may provide a benchmark for comparison of e-scooter injuries and may highlight a different safety and healthcare cost picture compared to reviewing e-scooter injury data in isolation. While cycling has the added advantage of physical activity, this orthopaedic unit manages three times as many injured cyclists as e-scooter riders.
Future audits could be more accurate if hospital coding could identify when Emergency Department presentations were related to micro-mobility device accidents. Policymakers may consider this data in relation to decisions on whether to continue e-scooter trials in Melbourne, as orthopaedic injuries from e-scooters were significantly less prevalent than injuries from cycling.
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