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. 2016 Jan 11;2(1):e000042.
doi: 10.1136/bmjsem-2015-000042. eCollection 2016.

Complex shoulder girdle injuries following mountain bike accidents and a review of the literature

Matthew Alexander Lea  1 , Navnit Makaram  2 , Makaram S Srinivasan  1
Affiliations

Complex shoulder girdle injuries following mountain bike accidents and a review of the literature

Matthew Alexander Lea et al. BMJ Open Sport Exerc Med. .

Abstract

Background: Mountain and road bike accidents are particularly common with the increased popularity of the sport. We reviewed the attendances in our emergency department over a 4-year period looking at cycling injuries to detect the level and grade of these injuries and their outcomes.

Method: Royal Blackburn Hospital caters for a population of 550 000. A search through the Hospital information system revealed 104 patients with fractures following mountain bike injuries. These were looked at in more detail. We present a series of 5 severe shoulder girdle injuries following mountain bike accidents in this cohort, to highlight the serious level of injury sustained in this sport. We searched MEDLINE and EMBASE databases over the past 10 years using the keywords, mountain, biking and fracture. This yielded 7 papers. We compared our series with the literature.

Results: 104 fractures following mountain bike accidents between 2008 and 2011. Fractures of the upper limb were the most common (88.5%) with the clavicle being the most commonly fractured bone (28.8%).

Conclusions: Major scapular injuries with destruction or disruption of the four bar linkage of the shoulder girdle are very common following mountain accidents. Clavicular fractures are the commonest upper limb injury. It is easy to miss a disruption to the four-bar linkage associated with a clavicular injury. This paper highlights the severity of the injuries sustained in mountain bike accidents of the upper limb and requirement of adequate protection in this exhilarating sport.

Keywords: Mountain biking; Shoulder; Trauma.

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Figures

Figure 1
Figure 1
(A) Anatomy of the superior shoulder suspensory complex (SSSC). (B) The three components of SSSC. (C) Complex shoulder girdle injuries with single (type I) and double (type II) disruptions.
Figure 1
Figure 1
Continued.
Figure 2
Figure 2
Patient A: (A) preoperative and (B) postoperative fixation images.
Figure 3
Figure 3
Patient B: (A) preoperative and (B) postoperative images.
Figure 3
Figure 3
Continued.
Figure 4
Figure 4
Three-dimensional reconstruction of the shoulder of patient C following injury.
Figure 5
Figure 5
X-ray demonstrating the postoperative fixation of patient D.
See this image and copyright information in PMC

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