Mapping fractures from traffic accidents in Sweden: How do cyclists compare to other road users?

Abstract

Introduction: Cyclists account for a large share of injured road users in traffic. The crash data analysis for cyclist safety and protection should be based on a representative dataset of real-world crashes. This manuscript aimed to explore the patterns of cyclists’ fractures and factors associated with fractures of higher severity.

Methods: This paper exemplifies a methodology that combines injuries from a crash database, including both hospital and police reports and fracture registry database from orthopedic centers nationally in Sweden.

Results: Car occupants were most frequently involved in crashes resulting in fractures (37%), followed by motorcyclists (27.6%) and bicyclists (15.4%). Common fracture locations differed by the type of road user, where cyclists were more frequently fractured in the lower arm, compared to other road users, such as car drivers, motorcyclists and pedestrians who suffered mostly of fractures in the lower leg. Within cyclists, injuries also differed by gender, suggesting that combination of different countermeasures may be needed in order to provide sufficient protection for all cyclist. In the analyzed data, male cyclists with an average age of 49 were the most frequently fractured cyclists. Fractures of cyclists to the acetabulum (100%), pelvis (84.2%), vertebra (75%) and tibia (70.3%) were most frequently high energy fractures. Single bicycle incidents (OR = 0.165) and collisions with another bicycle (OR = 0.148) were significantly less likely to result in a high energy fracture than a collision with a car.

Conclusions: The results of this study may guide the design of appropriate protective devices for the cyclists based on the different injury mechanisms and provide implications for prioritizing new countermeasures, campaigns, or regulations.

Keywords:

• Bicycle
• fracture
• injury
• transportation
• cyclist

Acknowledgments

We would like to thank Marianne Andersson and Robert Thomson for the discussions and earlier involvement in the project. We would also like to thank Jan Ekelund and Michael Möller from SFR for their support and assistance. The work was carried out at the SAFER Vehicle and Traffic Safety Center at Chalmers University of Technology, Gothenburg, Sweden.

Additional information

Funding

This study was supported by project ‘Skademekanismer vid cykelolyckor som resulterat i frakturer’ (TRV 2016/86288), sponsored by Trafikverket (the Swedish national road authority), Sweden.