Finger injuries to children involving exercise bicycles

OBJECTIVE: A previously unreported source of injuries to children, the exercise bicycle, is identified and the associated injuries and their treatment are described. DESIGN: A retrospective review of clinical records and the records of the Victorian Injury Surveillance System. SETTING: The Plastic Surgery Unit of the Royal Children's Hospital, Parkville, Victoria. PATIENTS: Seventeen children with finger injuries from exercise bicycles presented to the Emergency Department of the hospital and one presented to one of us (K L M) at his private practice. Sixteen of the 18 children were under five years of age; 10 were less than two years of age. Five times as many boys as girls were injured. INTERVENTIONS: Fourteen children required surgical treatment of their injuries. RESULTS: Four children had superficial injuries not in need of surgical repair. Eleven children had single digit injuries--five had injuries that were repaired by suture; five had complete avulsion of the tip of the digit that required flap graft repair; and one child underwent amputation of the index finger. Three boys had multiple digit injuries, each one requiring the amputation of a digit and repair of other digits. Two of these boys underwent replantation of a digit; only one replantation was successful. CONCLUSIONS: The most dangerous parts of the exercise bike were the wheel, the chain and the sprocketwheel. Design modifications and education of parents about the risks for children playing near exercise bikes are warranted.