Motorcycle Wheel Spoke Injury to the Ankle and Foot in Children: A Cross-sectional Observational Study.

Background: In developing countries, motorcycles are a widespread transportation method, leading to a notable increase in road traffic injuries, particularly those involving the ankle and foot caused by motorcycle wheel spokes.

Aims and objectives: Our study sought to understand the epidemiological features and characteristics of motorcycle-induced wheel spoke injuries to the ankle and foot in children. The objectives were to comprehend injury patterns, evaluate their severity and pinpoint clinical indicators predicting injury nature and extent, aiming to guide prevention strategies.

Materials and methods: We conducted a cross-sectional observational study with a retrospective data collection focused on children under the age of 16 years who sustained injuries from motorcycle rear wheel spokes while riding as pillion passengers and were admitted to our department over 11 years, from 1 January 2010 to 31 December 2020, with a minimum follow-up of 2 years. Soft tissue wounds were classified using the Oestern-Tscherne classification.

Results: Thirty patients were enrolled in this study. Before 2015, cases ranged from none to one annually, increasing to 2-7 cases per year after 2015. The average age was 6.7 ± 2.1 years. Significantly, more patients were older than 6 years (P < 0.001), injured on the right side (P < 0.001) and suffered the injuries in the afternoon (P < 0.001). All patients were pillion and were injured by the motorcycle's rear wheel. Twenty-five patients (83%) had a Grade 3 injury. There was a tendon rupture in 22 (73%) and a bone fracture in 15 (50%) patients. Loss of soft tissue (P = 0.036) and reduced ankle mobility (P = 0.046) were linked to tendon ruptures. Lengths of wound exceeding 6 cm (P = 0.025) and loss of soft tissue (P = 0.025) were associated with a bone fracture.

Conclusion: Children's motorcycle wheel spoke injuries have increased in recent years. Loss of soft tissue and ankle mobility deficit proved to be reliable clinical signs of a tendon rupture. A wound length exceeding 6 cm and a loss of soft tissue were indicative of a related bone fracture.