Sir.—We read with interest the recent editorials1,2 and article3 on bicycle injuries in children. We report an additional complication of this pursuit seen in hemophiliac patients attending the Birmingham Children's Hospital in England.
Patient Reports.—Over the 12 months preceding this report, four patients with severe hemophilia (VIII:C, <0.01 U/mL) presented with obscure perineal or adductor compartment hematomas. All four patients had recently acquired BMX bicycles as Christmas or birthday presents, and their "spontaneous" bleeds were associated with BMX bicycle usage. There was no other history of trauma. Restriction of BMX bicycle activities prevented recurrence of the lesions. Many of our hemophiliac patients have bicycles, but this particular injury is rare and has been seen only in BMX riders. This may be due in part to the design of the saddle and in part to the athletic nature of BMX bicycle riding.
Comment.—We would like