Changes in the etiology of orbital fractures over 2011–2022: the role of age and electric bicycles

Purpose: Traffic accidents are a common cause of orbital fractures. In The Netherlands, the number of traffic accidents as well as the use of electronic bicycles (e-bikes) is increasing. The aim of this study was to investigate changes in the etiology of orbital fractures, especially the role of e-bikes and population ageing. Methods: A retrospective cohort study at the Leiden University Medical Center (LUMC) was performed to identify the causes of orbital fractures in a single center. Medical records of patients presenting with periorbital trauma in the period 2011–2022 were reviewed to identify patients with orbital fracture. For each year and for different age categories the number of fractures, and causes per year were analyzed. Results: From 1099 patient records, 495 patients with orbital fracture were identified. We found a statistically significant increase of orbital fractures: 35 in 2012 and 82 in 2022. Most orbital fractures were caused by bicycle accidents (men 31%, women 44%). The highest increase in orbital fractures due to e-bikes was in patients aged between 50 and 75 years. Conclusion: The number of orbital fractures is increasing, especially orbital fractures due to e-bike accidents and mostly in patients aged 50 years and older.