Bicycle-spoke and "doubling" injuries.

A "doubling" injury is the result of two persons, usually two children, but often an adult and a child, riding on a bicycle. The most-common variety is the "bicycle-spoke injury" which is sustained when the passenger's foot is caught in the spokes of the wheel. Between August 1, 1986 and July 31, 1987, 43 children (mean age, 55 months) attended the Emergency Department of Princess Margaret Hospital for Children with such an injury. None of the bicycles had spoke-guards. Sixteen children were admitted to hospital: eight children required skin grafts and four children required repair by sutures. Nineteen (44%) of the children had bare feet when they were injured. The healing time ranged from seven to 365 days with an average of 56 days, which was long enough to ruin a child's holiday. This injury can be prevented. "Doubling" is dangerous and should be prohibited where seats and spoke-guards are not available. The attention of parents and the community should be drawn to the potentially-serious nature of these injuries.