Bicycle-Related Acetabular Fractures Are Associated with Anterior Column Involvement: A Multicenter Study with an Exploratory Analysis of Clipless Pedal Use

Background/Objectives: Cycling-related acetabular fractures have not been well described. We aimed to determine the proportion of acetabular fractures associated with bicycle accidents and to compare their fracture patterns with those caused by other mechanisms. Findings related to clipless pedal use were considered exploratory.

Methods

Patients treated for an acetabular fracture between January 2010 and December 2023 were identified by ICD-10 codes from a university hospital network Clinical Data Warehouse. After exclusions, 378 patients with 385 fractures were classified according to the Judet–Letournel system. Fracture-pattern proportions were compared using Fisher’s exact test, and the association with anterior column involvement was examined with logistic regression adjusted for age and sex. Cleat-shoe status, obtained from medical records or telephone interviews, was analyzed descriptively.