Spoke-wheel injuries

Abstract

Spoke-wheel injuries of lower extremity are frequently suffered by young children in bicycle or moped accidents. They are trivial looking in nature and the full extent of damage is not evident for 24–48 hours. This study comprises 46 cases with predominance of males (28) over females (18), involving right-side in 32 cases (69·6%), and the maximum incidence being in 3–5 years age-group (52·2%). Forty cases involve persons injured by bicycle in motion, with more than two-thirds sitting over the horizontal bar in front either cross-legged or sideways. Nearly two-third cases (30) were reported to this department within 8 to 48 hours of the accident with marked swelling over foot and ankle. In this series, two had fracture-separation of lower tibiofibular epiphysis and the other two had spiral fracture of lower third tibia while one had disarticulation of hallux. Dorsolateral aspect of foot and ankle were more vulnerable to injury (60·9%).