Background/Objectives: In recent years, electric scooters have gained widespread popularity as an easy and affordable mode of transport in urban areas worldwide. Simultaneously, trauma centers have observed an increasing number of associated injuries to users. While injury patterns associated with other vehicles are now well-researched, electric-scooter-related injuries are a new topic in the literature. Our study aims to investigate the differences in injury patterns and other critical crash characteristics among riders of bicycles, electric scooters, and scooters. Methods: This one-year retrospective observational study examined patients who sustained injuries while riding bicycles, electric scooters, or scooters between April 2021 and March 2022 at Hungary’s largest trauma center in Budapest. During this one-year period, we identified 1938 patients, 1378 cyclists, 370 electric scooter users, and 190 scooter users. Basic demographic information, recorded injury type and severity, time of day the injury occurred, and alcohol usage were recorded as outcome measures. Results: While 4.6% of cyclists and 5.8% of scooter riders had consumed alcohol, 26.8% of electric scooter riders were under the influence of alcohol at the time of their crash. Of electric-scooter-related injuries, 45.8% occurred at night, compared to only 9.2% and 14.1% of bike and scooter-related injuries, respectively. E-scooter crashes constituted 19.1% of total cases but surged to 52.3% at night. Patients under the influence of alcohol were much more likely to experience mild head injuries (p < 0.0001) and severe head injuries (p < 0.0001), but less likely to suffer mild limb injuries (p < 0.0001) and severe limb injuries (p < 0.0001) compared with sober patients. Cyclists had significantly 3 times fewer cases of severe head trauma than those injured while using electric scooters (p = 0.0166). Conclusions: The study highlights a significant risk of severe craniofacial injuries in e-scooter users after consuming alcohol, exceeding that in sober riders and cyclists. Predominantly occurring at night, these injuries are closely linked with alcohol use. The findings advocate for mandatory helmet laws and stricter regulations on e-scooter use to enhance safety, especially at night.

Background: Cement leakage remains a significant challenge in percutaneous vertebroplasty (PVP). Leakage can lead to serious complications, including spinal cord compression, pulmonary embolism, and nerve root irritation. While several techniques have been proposed to minimize leakage, an effective and simple solution is still needed. This study investigates the impact of pre-washing vertebral bodies with cold saline before cement injection as a potential method to reduce leakage. Methods: A retrospective analysis was conducted on patients who underwent PVP for osteoporotic vertebral compression fractures. Patients were divided into three groups: (1) conventional PVP, (2) PVP with room-temperature saline pre-injection, and (3) PVP with cold saline (4 °C) pre-injection. Cement leakage was assessed using intraoperative fluoroscopy and postoperative computed tomography (CT), categorized into paravertebral, intervertebral, retrograde, spinal canal, and distant venous leakage. Statistical analysis was performed to compare leakage rates among the groups. Results: A total of 262 patients with 461 treated vertebrae were analyzed. Cold saline pre-treatment significantly reduced cement leakage rates compared to conventional PVP and room-temperature saline pre-injection (p < 0.05). CT imaging detected significantly more cement extravasation than fluoroscopy (p < 0.01). The incidence of spinal canal and intervertebral leakage was lowest in the cold saline group, suggesting improved cement containment and distribution. Conclusions: Pre-washing vertebral bodies with cold saline before cement injection in PVP significantly reduces cement leakage, particularly in the spinal canal and intervertebral spaces. This simple and cost-effective approach may enhance surgical safety and improve patient outcomes.

Background/Objectives: Vertebral fractures are frequently underdiagnosed after minor trauma in patients with normal or mildly reduced bone mineral density (BMD). CT, the standard first-line imaging, may miss subtle fractures, while STIR MRI is more sensitive but not routinely applied. We evaluated whether DEXA-derived T-scores can guide selective use of STIR MRI in patients > 50 years. Methods: We retrospectively analyzed 214 patients who underwent CT, sagittal whole-spine STIR MRI, and DEXA within 48 h after minor trauma. Fracture counts were compared using the Wilcoxon signed-rank test. Spearman’s correlation examined associations between T-score and fracture counts. Subgroups were defined as normal (≥−1), osteopenia (−2.5 < T-score < −1), osteoporosis (−3.5 < T-score ≤ −2.5), and high-risk osteoporosis (≤−3.5). Results: STIR MRI identified more fractures than CT in 87 patients (40.7%), while CT detected more in 19 (8.9%) (p < 0.0001). MRI outperformed CT across all T-score categories. The osteopenia group had the highest number of additional fractures (n = 53), and even patients with normal BMD showed a notable yield (n = 36). Correlations between T-score and fracture counts were weak and not statistically significant. Conclusions: T-score can support imaging triage but should not be used as a strict threshold. STIR MRI is justified in patients with T-scores < −2.5 when clinical suspicion exists and should be considered in those with higher T-scores if CT is negative but symptoms persist. Integrating T-score into imaging protocols may reduce missed fractures and improve outcomes.

Background: Vertebral fractures are the most common osteoporotic fractures and are frequently underdiagnosed. Although prior fragility fractures increase the risk of subsequent fractures, the magnitude and distribution of extremity fracture risk following vertebral fractures remain incompletely defined. Objective: The objective of this study is to evaluate the risk of subsequent extremity fractures following vertebral fractures in adults aged ≥50 years and to characterize fracture patterns and timing. Methods: A systematic review was conducted using three databases (PubMed, OVID, and Scopus) covering studies published between January 2005 and December 2025. Studies reporting subsequent extremity fractures after an index vertebral fracture in adults aged ≥50 years were included. Data extraction included patient demographics, fracture characteristics, treatment variables, and incidence of subsequent fractures. Results: Eight studies were included in the qualitative (narrative) synthesis, comprising a total of 488,770 patients with an index vertebral fracture. The reported incidence of subsequent extremity fractures ranged from 1.4% to 12.4%, with a crude aggregated incidence of 6.90% (33,605 patients). Hip fractures accounted for 73.3% of extremity fractures, followed by forearm/wrist (11.8%), humerus (10.3%), and ankle fractures (3.26%). Most subsequent extremity fractures occurred within 1–3 years after the index vertebral fracture. Additionally, 23,542 patients (4.82%) experienced subsequent vertebral fractures. Rates of dual-energy X-ray absorptiometry utilization and pharmacologic treatment ranged from 5% to 34.5%. Conclusions: Vertebral fractures in adults aged ≥50 years are strong predictors of subsequent extremity fractures, particularly hip fractures, with risk concentrated in the early post-fracture period. These findings support the concept of a systemic fracture cascade and emphasize the need for early detection and structured secondary prevention strategies.