Orbital trauma caused by bicycle hand brakes.

Abstract

PURPOSE:

This report aims to increase awareness of an unusual mechanism of orbital injury sustained by bicycle riders.

METHODS:

In this retrospective small case series, we describe two cases of orbital injury caused by upper eyelid penetration. A 5-year-old boy (patient 1) and a 6-year-old boy (patient 2) presented to our service within a 2-week period. Both had been injured by similarly styled, handlebar-mounted bicycle hand brake levers. Patient 1 had an orbital roof fracture and penetrating brain injury and underwent repair of a left upper eyelid laceration, craniotomy for pseudoencephalocele, and ptosis repair. Patient 2 had orbital hemorrhage and underwent repair of left upper eyelid laceration.

RESULTS:

In both cases, a handlebar-mounted bicycle hand brake lever perforated the left eyelid when the rider fell onto it. Neither patient was wearing protective headwear or eyewear. Two months after surgery, patient 1 had 20/25 visual acuity OU and excellent cosmetic appearance. Patient 2 had baseline amblyopic vision 2 days after surgery but moved from town and was lost to follow-up.

CONCLUSIONS:

Orbit injuries from bicycle brake levers are rare, and helmets or protective eyewear probably would not have prevented these injuries. However, a change in the design and/or mounting location of handlebar-mounted brake levers might help prevent further injuries of this type.

• Authors: John D Ng, Troy D Payner, David E E Holck, Ronald T Martin, William T Nunery
• Journal: Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) Vol. 20 Issue 1 Pg. 60-3 (Jan 2004) ISSN: 0740-9303 [Print] United States
• PMID: 14752313 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Bicycling (injuries)
• Blepharoptosis
• Brain Injuries (diagnostic imaging, etiology, surgery)
• Child
• Child, Preschool
• Craniotomy
• Encephalocele (diagnostic imaging, etiology, surgery)
• Eye Hemorrhage (diagnostic imaging, etiology, surgery)
• Eye Injuries, Penetrating (diagnostic imaging, etiology, surgery)
• Eyelids (injuries, surgery)
• Humans
• Male
• Orbital Fractures (diagnostic imaging, etiology, surgery)
• Retrospective Studies
• Tomography, X-Ray Computed