Upper extremity injuries among vulnerable road users struck by passenger cars

Paper in proceeding, 2026

Upper extremity injuries are common among vulnerable road users (VRUs) and often result in long-term consequences for the injured VRU. As a first step towards prediction and mitigation of these injuries, this study sought to identify in what situations upper extremity injuries occur, what parts of the upper extremity are most often injured and potential patterns in the prevalence of upper extremity injuries. By analyzing Swedish insurance data from the years 2020-2024, this study found that in general, accidents resulting in upper extremity injuries follow the general distribution of car to VRU crashes. Pedestrians were more likely to sustain upper extremity injuries given a collision with a car compared to bicyclists and e-scooter riders. The most injured area of the upper extremity was the wrist among bicyclists (31%), the shoulder among pedestrians (37%) and the hand among e scooter riders (29%). Older (65 years old or older) females were overrepresented, both when considering upper extremity injuries in general and those sustaining multiple upper extremity injuries. Being struck by a new vehicle resulted in similar upper extremity injury risks as colliding with older vehicles and most injuries occurred when impacting both the vehicle and the ground. This study recommends focusing future studies on injuries to the wrist and shoulder and investigate the underlying injury mechanisms.