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E-scooter injuries can come at a cost to the public

Orthopedic care expenses often absorbed by local communities, UT Southwestern study suggests

Electric scooters carry a significant risk of orthopedic injuries and associated costs for medical care, which can create a financial burden for the public, according to a study by UT Southwestern Medical Center researchers. The findings, published in the Journal of Orthopaedic Business, could have policy implications for the vehicles, which are available through vehicle-sharing programs in many cities worldwide.

Drew Sanders, M.D., M.P.H.

Drew Sanders, M.D., M.P.H., is Associate Professor of Orthopaedic Surgery and Residency Program Director at UT Southwestern Medical School. He holds the Aaron A. Hofmann, M.D. and Suzanne Hofmann Distinguished Chair in Orthopedic Surgery in Honor of Richard E. Jones, M.D.

“E-scooters go up to 20 miles per hour, but people are allowed to ride them on sidewalks with no safety equipment. It’s no surprise that many riders have had high-energy traumas, and their communities often absorb the cost,” said Drew Sanders, M.D., M.P.H., Associate Professor of Orthopaedic Surgery and Residency Program Director at UT Southwestern Medical School.

Like many large cities, Dallas offers vehicle-sharing programs that provide short-term rentals of electric bikes, e-scooters, and other vehicles at low cost. Dallas removed e-scooters from its program in 2020 due to safety and oversight concerns but reinstituted them in the spring of 2023. E-scooters also are privately owned by a growing number of individuals for traveling short distances such as in-town commutes.

Curious about the number of orthopedic injuries caused by e-scooter accidents and their related costs, Dr. Sanders and his colleagues analyzed medical records of patients from Parkland Memorial Hospital, a public hospital and Level I trauma center that serves Dallas County and is UT Southwestern’s primary teaching facility. Parkland is funded by county residents through property taxes to provide safety net care for those without insurance. Consequently, part of treatment costs at the hospital are absorbed by the community.

The team members searched medical records to identify individuals who sustained orthopedic injuries from e-scooter accidents between January 2017 and August 2020 – before e-scooters were removed from Dallas’ vehicle-sharing program. They identified 82 patients seen for orthopedic injuries linked to e-scooters. About 70% were male, with an average age of 34. About 64% were employed, but only 33% had private insurance – 21% were on county-funded or discounted coverage offered through Parkland for qualified county residents, 2.4% were covered by Medicaid, and the remaining 44% were uninsured.

Chart on stats for e-scooter injuries

Records showed the most common injuries were elbow and ankle fractures, although other types of fractures and dislocations also occurred frequently. Hospital admission was required for about 30% of the cases, trauma activation was necessary for about 15%, and about 23% required emergency medical service transport to the hospital. Just over a third required surgery for their orthopedic injuries.

Orthopedic services for these 82 patients cost more than $2.3 million, averaging about $28,406 each. Because two-thirds of these patients were either uninsured or insured by the public hospital system, the community bore most of this cost, Dr. Sanders said.

“Given the magnitude of associated health system costs demonstrated within this study, the financial burden to the city or taxpayers may be of additional consideration when regulating this burgeoning form of transportation,” the authors concluded.

Dr. Sanders holds the Aaron A. Hofmann, M.D. and Suzanne Hofmann Distinguished Chair in Orthopedic Surgery in Honor of Richard E. Jones, M.D.

UTSW Orthopaedic Surgery Resident Emily Skarda, M.D., also contributed to this study, along with several other Orthopaedic Surgery residents who have since completed their training.

About Parkland Health

Parkland Health is one of the largest public hospital systems in the country. Premier services at the state-of-the-art Parkland Memorial Hospital include the Level I Rees-Jones Trauma Center, the only burn center in North Texas verified by the American Burn Association for adult and pediatric patients, and a Level III Neonatal Intensive Care Unit. The system also includes two on-campus outpatient clinics – the Ron J. Anderson, MD Clinic and the Moody Outpatient Center, as well as more than 30 community-based clinics and numerous outreach and education programs. By cultivating its diversity, inclusion, and health equity efforts, Parkland enriches the health and wellness of the communities it serves. For more information, visit