Pediatric e-bike injuries are most often fractures, NEISS analysis finds

Fractures were the most common injury among children and adolescents treated in emergency departments for e-bike-related injuries, according to research presented at the American Academy of Pediatrics (AAP) 2026 National Conference & Exhibition in San Diego, California.¹^,² The analysis compared pediatric injuries related to e-bikes, conventional bicycles, and gas-powered cycles using national emergency department surveillance data.²

The authors noted e-bikes are becoming increasingly common in the United States, and their ability to accelerate quickly and reach high speeds increases the chance for injury compared with pedal-powered bicycles.² They stated comparisons of injuries and disposition among e-bikes, bicycles, and gas-powered cycles had not yet been studied.²

"In the pediatric trauma setting, electronic bicycles are becoming increasingly common," study author Seth Weir, DO, a third-year general surgery resident at Stony Brook University in Stony Brook, New York, said in a press release. "The goal of this research was to better inform parents when buying electric assist powered bicycles and adequately portray the risk of injury in each type."

NEISS data compare pediatric e-bike, bicycle, and gas-powered cycle injuries

Investigators conducted a retrospective cross-sectional analysis of the National Electronic Injury Surveillance System (NEISS), a stratified probability sample of US hospitals with emergency departments, from 2005 to 2024.² The analysis included patients 17 years or younger with injuries related to e-bikes, bicycles, or gas-powered cycles.² Variables included patient demographics, injury characteristics, anatomical location, diagnosis, and emergency department disposition.²

National estimates were generated using sampling weights from the Consumer Product Safety Commission.² A total of 134,426 cases involved bicycles, 305 involved e-bikes, and 1721 involved gas-powered cycles.² Most cases in all 3 groups involved male patients, and White patients were the most frequently affected racial group across subgroups.²

Mean age was 12.43 years (SD, 3.71) for patients with e-bike injuries, 9.67 years (SD, 3.96) for bicycle injuries, and 13.13 years (SD, 3.69) for gas-powered cycle injuries.² The head was the most frequent injury location in all 3 groups, accounting for 20% of e-bike injuries, 16.6% of gas-powered cycle injuries, and 15.8% of bicycle injuries.²

E-bike injuries more often led to admission than bicycle injuries

Fracture was the most common injury type for e-bikes (27%), whereas contusion or abrasion was most common for bicycles (24%) and gas-powered cycles (27%).²

Most patients were treated and released, including 92% of patients with bicycle injuries, 90% with e-bike injuries, and 87% with gas-powered cycle injuries.² Gas-powered cycles had the highest admission rate (10%), followed by e-bikes (6.6%) and bicycles (5%).²

Fatalities were documented in all 3 groups. There was 1 e-bike fatality (0.32% of e-bike cases), 2 gas-powered cycle fatalities (0.12%), and 37 bicycle fatalities (0.03%).²

The authors described e-bikes as having high potential for injury in the pediatric population.² They noted hospital admission and fatalities were rare, but they concluded the e-bike fatality and admission percentages indicate a need for further regulation.² The authors proposed strategies such as requiring a driver's license or regulating the speed of e-bikes for pediatric age groups.²

The abstract reports descriptive percentages without statistical comparisons between groups. The e-bike group included 305 cases and 1 fatality, and the abstract did not specify whether percentages reflect raw cases or weighted national estimates.

References

1. American Academy of Pediatrics. Children, teens experience more injuries on electronic or gas-powered bikes than pedal-assist. Eurekalert. October 2, 2026. Accessed October 2, 2026. https://www.eurekalert.org/news-releases/1145264

2. Weir S, Langbart K, Sriram V, Kotikovski M, Gow KW, Hsieh H. Comparison of bikes, e-bikes, and gas-powered cycle injuries in the United States: a national review from 2005-2024. Abstract presented at: American Academy of Pediatrics 2026 National Conference & Exhibition; October 2-6, 2026; San Diego, CA.