A prospective study of bicycle-spoke injuries was undertaken to assess the severity of soft tissue damage and the incidence of skeletal injuries. During a 12 month period, 59 children with spoke injuries were examined. Soft tissue damage was divided into three categories: bruising without laceration (four), bruising and superficial abrasions (49) and full thickness skin defects (six). Seventeen children had skeletal injuries: nine tibial fractures (five greenstick fractures and four spiral fractures) and eight epiphyseal injuries of the distal fibula. All fractures were treated non-operatively. The mean time for soft tissue healing was 16.5 days and the mean time for regaining full weight-bearing was 8.5 days. Soft tissue damage is the most important prognostic factor in the healing of a bicycle-spoke injury.