FOOT & ANKLE INJURIES IN MOTORCROSS RIDERS: AN ANALYSIS OF INJURY PATTERNS

Abstract

Motorcross motorbiking has seen a great upsurge in popularity since the year 2000 globally. With extreme sports come extreme injuries, characterised by high energy trauma patterns. 55% of all such injuries are orthopaedic in nature, with a significant proportion comprising foot and ankle injuries. In New Zealand, ‘recreational motorbiking’ as a category made up 2.3% of all ACC coded sporting injuries in the year 2002. At Middlemore Hospital we have seen a greatly increased number of motorcross injuries over the past decade. To date, there is a dearth of literature (particularly in Australasia) on this injury group.

The current study was a retrospective review of 208 episodes of trauma in 176 patients between February 1993 and June 2005, at Middlemore Hospital. Thirty-one of these trauma episodes in 30 patients were foot and ankle trauma (17% of patients, 15% of all trauma episodes).

The aims of the study were to describe the demography of the motocross injury patient population, any associations between modes of injury and resultant injury patterns and to identify any injury clusters peculiar to the motorcross foot and ankle injury subgroup. A better understanding of these factors will ultimately improve injury identification and management of motor-cross foot and ankle trauma at primary contact.

The study found that the majority of patients are male and Caucasian. The mean age was 26 years (range: 8–55 years). Seven of the 31 cases (22.5%) represented multi-trauma presentations. The majority of injuries occurred in group whereby a rider was ejected from bike (22/31). Twelve out of 31 cases had ‘polybone’ trauma in the foot (with all forefoot trauma being ‘polybone’ in nature) There was a clinically observed injury association between ankle and talus fractures. Four of 20 forefoot injuries required an operation, while 32 of 37 (86.5%) midfoot, hindfoot, ankle and intra-articular distal tibial injuries required operations.

We conclude that foot and ankle trauma represents a significant proportion of all orthopaedic motorcross trauma that is seen at this institution. Over one in five injuries involving the foot and ankle are multi-traumatic in nature, with rider ejection perhaps playing a role. Over four out of five injuries extending proximally from the midfoot required operative management. Foot and ankle motorcross injuries are frequently high energy in nature and their assessment requires a moderate index of suspicion for other bone injuries in the foot, as well as elsewhere.