E-scooter-related injuries: will the new Italian Highway Code slow the epidemic?

Electric scooters (e-scooters) have become a common means of urban transport, with a parallel rise in associated traumatic injuries. This increase in lesions is leading governments to update their road regulations. This study describes the epidemiology, mechanisms, and injury patterns of e-scooter–related trauma in a large metropolitan setting. A retrospective double-center observational analysis was conducted in two trauma departments in Rome, including all patients who presented with e-scooter–related injuries between 2018 and 2024 and required specialized videat. Demographic, temporal, clinical and surgical data were collected from electronic medical records. A total of 441 patients were included (mean age 29.9 years; 71% male). Most riders were aged 15–35 years (70%). Accidental falls represented the leading mechanism (78%), often caused by uneven or slippery surfaces or rider distraction; collisions accounted for 22% of cases. Only 36 riders wore a helmet. Incidents occurred throughout the week, with a peak on Fridays. Seasonally, 63% of cases occurred in warm months, particularly in September (87 cases). Craniofacial, maxillofacial, dental, or neurosurgical injuries affected 24% of patients. Orthopaedic trauma was identified in 79% of cases: the upper limb was involved in 205 cases and the lower limb in 129, with nine patients sustaining injuries to both. Overall, 170 fractures (49%) and 16 dislocations (5%) were recorded. The most frequent fracture sites were the wrist, radial head, clavicle, and proximal humerus in the upper limb, and the ankle, tibial plateau, patella, and tibial shaft in the lower limb. Surgical treatment was required in 27% of upper limb and 25% of lower limb fractures. E-scooter use is associated with significant trauma, particularly among young adults, with frequent craniofacial and upper limb involvement. The high fracture rate, limited protective equipment use, and substantial need for surgery underline the importance of preventive measures and improved urban safety policies. Several European cities have already significantly restricted the use of e-scooter sharing services in city centers.