Motorcyclist "biker couples": a descriptive analysis of orthopaedic and non-orthopaedic injuries.

The term "biker couple" is becoming an increasingly common site in emergency departments. The purpose of this study was to identify orthopaedic and non-orthopaedic injury patterns among this unique patient group. A 14-year (1993-2006) retrospective review of a Level I Trauma Institute Registry was performed. Patient demographic and injury data were obtained from 21 confirmed biker couples (n=42). Nineteen of 21 biker couple pairs (90.5%) included a male driver and a female passenger. Drivers were more likely to have a positive blood alcohol concentration/toxicology test. Drivers had a greater incidence of scapular and rib fractures than passengers. Both drivers and passengers who sustained scapular fractures had a greater incidence of clavicle, rib, pelvis, and fibula fractures. Drivers with scapular fractures had a greater incidence of thoracic spine fractures, while passengers with scapular fractures had a greater incidence of arm-forearm-wrist-hand, femur, tibia, and foot-ankle fractures. Overall, biker couple drivers and passengers did not differ for head injury, pulmonary system, road rash, aortic injury or visceral injury. Both drivers and passengers with scapular fractures had a greater incidence of head injuries, and passengers had a greater incidence of pulmonary system, visceral injury and road rash. Both drivers and passengers who were not wearing a helmet had a greater incidence of head injuries. Unhelmeted drivers were more likely to sustain head injury than passengers. When a scapular fracture was present both drivers and passengers had a greater incidence of head injuries. Prospective investigations are needed to better delineate the precise mechanisms for these injury patterns.