Abstract Bicycle spoke injuries to the lower extremeties, especially the malleoli, of children present a significant problem in management because of the “minor” appearance of the initial injury. Treatment is frequently casual because the extent of the injury is not recognized and its potential harm not appreciated. Injury usually results from the sudden, forceful trapping of the foot between the spokes and frame of a bicycle. It is probably a common injury, since more than 150,000 pedal bicycle injuries occur in the United States of America each year. 1 Our experience in the past 4 years with 60 cases under 14 years of age prompts us to call attention to this entity as injury that requires special consideration.