Introduction
Approximately 400 000 sport accidents happen in Switzerland per year. The Swiss Council for Accident Prevention BFU releases annual accident statistics for Switzerland: The number of accidents in 2014 in the section ‘other cycling and skating sports’ was 10 180, and this number increased from 8120 in 2000.1 Likewise we notice an increase in adults visiting our emergency department due to accidents with push scooters over the last years. Nearly two decades have passed since the launch of the first push scooter in Switzerland in 1999.2 The Swiss company Micro Mobility Systems AG (Küsnacht, Switzerland) modified the traditional model form of the early 1950s. The new model is a more lightweight version made of aluminium, weighing less than 5 kg, and easily foldable for convenient transportation and storage.3 The technical innovations of the new push scooter compared with the traditional model are the following: it has a narrow base with a high centre of gravity, the wheels are of low friction, made of massive polyurethane and of variable diameter (100–200 mm). Steering is performed with height-adjustable T-handlebars, and braking is performed by pressing one foot against the rear-wheel mudguard.2–13 These scooters are mainly used by children for recreation, but adults use push scooters for transportation in urban traffic areas and in big building complexes.4 In recent years, ‘downhill scooters’ have become increasingly popular in the Swiss Alpine region. These scooters have larger pneumatic tyres, rather than tyres made of massive polyurethane, so that their owner can ride mountain roads downhill during snow-free seasons.14
The sales statistics of Micro Mobility Systems AG from 1999 to 2017 show increasing sales of up to 1 000 000 units worldwide and a market share of 10% in 2017 (Marcus Porsche, Deputy CEO, Micro Mobility Systems AG, December 2017). As there are other companies that sell their own models of push scooters, similar increases in their sales can be assumed. We therefore expect that increasing numbers of adults will present to our emergency department due to push scooter accidents.
Paediatric studies have found injuries in different areas of the body: the lower limbs,4 the upper limbs,8 10 13 15 and the head and face.7 9 Wearing a helmet seems to reduce the risk of traumatic brain injury,16 but at the same time another study reported a decrease in helmet use with increasing age of the rider.4 There is little published information on push scooter-related injuries in adults. Therefore, patient characteristics, injury patterns and optimal treatment for these patients remain unclear.
There are no official guidelines in Switzerland for protective equipment when driving push scooters. The total number of people using protective equipment varies; for example, helmet wear ranges from 4% up to 40% in the paediatric population.4 6 12 13 15–17 In contrast, injuries involving the head in children have a greater risk of hospitalisation and mortality, and there is always the potential of lifelong negative effects for the patient.18 The use of other equipment, such as elbow and knee pads, is estimated to be even lower.12 13 15
In 2001 our department published the first article worldwide about push scooter-related injuries in Switzerland, under the title The kick with the stick.2 Nearly two decades after our first publication, we wanted to look back and collect data on push scooter-related injuries in adults in the interim period. In this study, we describe injury patterns and severity and the management of these patients.