Eight-Year Study Examining Bicycling-Related Facial Fractures and Factors Contributing to Injury

Objectives: To determine the epidemiological characteristics of bicycling-related maxillofacial fractures in a defined population and to identify factors contributing to these injuries. Methods: An 8-year prospective analysis was carried out, including all patients presenting with bicycling-related maxillofacial fractures at a tertiary care center from 2017 through 2024. Data recorded for each patient included age, gender, date and cause of injury, risk factors, type of facial fractures, other injuries, hospital stay, and helmet use. Statistical analysis was performed using SPSS 20. Continuous variables were assessed for normality (Shapiro-Wilk test) and compared using the Mann-Whitney test. Categorical variables were analyzed with chi-square tests. A p-value ≤ 0.05 was considered statistically significant. Results: Out of 899 cycling accident patients seeking medical treatment, 122 (13%) sustained facial fractures, accounting for 4% of all facial fracture cases in our department during the study period. The male:female ratio was 2.6:1, and the mean age was 29.5 years (SD 12.8, range 13-77). Collision with another object/vehicle was the most common cause (64%), followed by isolated falls (36%). A total of 135 facial fractures were recorded (some patients had multiple fractures). Mandibular fractures were most frequent (49% of patients) followed by zygomatic (32%), orbital (13%), nasal (7%), maxillary (2%) and frontal (2%) fractures. Within mandibular injuries, condylar fractures were the most common subtype (63%). Concomitant injuries were present in 20% of patients, most often orthopedic limb injuries. Only 27% of patients reported always wearing a helmet, whereas 43% never more one. Conclusions: Bicycling-related facial injuries are a noteworthy subset of facial trauma. Missed or delayed diagnosis can lead to lasting deformities and functional issues. Preventive strategies –especially promoting helmet use and improving helmet design– along with broader safety measures are important to reduce the incidence and severity of these injuries.