Joanne Nutting is one of the 27 people who crashed a moped on the Vineyard last year and ended up in the emergency room at the Martha's Vineyard Hospital.

She's not only a grateful woman; she's also part of a statistic on the wane.

For the fourth year in a row, the number of moped riders injured in crashes and treated in the emergency room has decreased, according to a year-end study released this week by Dr. Alan Hirshberg, emergency services director at the Martha's Vineyard Hospital.

While the latest numbers speak to a decline in moped accident victims - down from 35 in 2002, 43 in 2001 and 66 in 2000 - they don't pinpoint a reason, and they don't paint a picture of what it's like to rent a moped and then wreck it.

Ms. Nutting, a 53-year-old kindergarten assistant teacher from Westminster, became one of the first crash victims of last summer when she lost control of her moped on a curvy stretch of Seaview avenue in Oak Bluffs and crossed the center line into oncoming traffic.

"I couldn't even steer the thing," she said this week in a telephone interview. It was the Wednesday before the Fourth of July. Her 14-year-old niece was a passenger riding on the back.

"It just fell, and I slid," she added. "I just went right under the car."

Her niece was unhurt. Ms. Nutting was not so lucky. Her right ankle was badly fractured, the broken bone piercing the skin. Her legs, hands and chin were bleeding, chewed up on the road surface.

"I didn't know I had broken my tibia and fibia," she said. "It was scary. Your mind goes blank. I'd burned my ankle on the moped exhaust. The bone was exposed."

She was treated at the Vineyard hospital, then taken by ambulance to Beth Israel Hospital in Boston, where surgeons pinned her ankle back together and where she spent the next six days recovering. She was unable to return to work until late October and is still limping.

She regrets the decision she made after arriving in Oak Bluffs for a one-day visit. "My husband suggested we go on a tour bus," she said. "I thought it would be more adventurous to rent mopeds."

But Ms. Nutting is also angry with the moped dealer - Ride-On Mopeds in Oak Bluffs. Though she had never ridden a moped before and was unable to recall the last time she rode a bicycle, Ms. Nutting said the training session consisted of riding the moped once around the block by herself. She wasn't asked to take a practice loop with her passenger on the back. She and her niece wrecked less than 30 minutes later.

But this week moped dealer Fran Alarie 3rd said that beefed-up training practices are probably helping bring down the rate of serious accidents. "One accident is too many," he said. "We're still trying to improve the safety."

Three years ago, anti-moped activists reached a compromise with dealers, convincing them to inform would-be renters of the dangers of moped riding on the Vineyard. In exchange, activists agreed to back off their lobbying in the state legislature to have moped rentals banned on the Island.

Four people have been killed in moped accidents on the Island since 1996. The last fatality was in 2001.

And since 2000, the total number of victims requiring medical treatment has fallen. In the aftermath of the 2001 tragedy, which was followed by another accident a week later that left a rider permanently brain damaged, Oak Bluffs selectmen began to revamp their bylaws and trim back the number of mopeds available for rent in their town, home to five of the six rental outlets on the Vineyard.

The fleet went from 539 to 308. Two moped dealership licenses were forfeited after selectmen agreed to a deal with Michael and Mark Wallace, trading moped licenses for a liquor license.

Sam Feldman, founder of a group called Mopeds Are Dangerous, said fewer mopeds on Circuit avenue extension - a gateway to the Island for many day-trippers - translates to " less exposure" and "less temptation" to rent one.

In Tisbury last year, selectmen tried - and failed - to cut back the number of mopeds for rent in their town. Moped dealer Robert Clermont won a court injunction after selectmen voted to cap his license at 25 mopeds. Mr. Clermont's business, Adventure Rentals on Beach Road, still has a license to rent 90 mopeds.

While Island officials know how many rental mopeds are available, they don't know exactly how many are rented in a season. Oak Bluffs selectmen demanded those figures from dealers this year, but only three of the five dealers turned in their numbers.

Sun 'n' Fun reported renting 1,028 mopeds last year. Two Wheel Traveler - Mr. Alarie's business - rented 2,207, and Ride-On Mopeds told selectmen they rented 2,263 for the season.

Interestingly, those three dealers collectively reported only seven accidents during the year. That statistic does not indicate how many riders, if any, were injured. But the hospital emergency room saw 27 moped victims last year, leaving open the question of whether the Island's other three dealers rented the remainder of the mopeds that ended up in crashes and injured riders.

Dr. Hirshberg said he would certainly like to know the total number of mopeds rented on the Island, since it would put his data in a more meaningful context.

For now, the statistics simply summarize what doctors and nurses in the ER saw over the season. Of the 27 people treated for injuries from a moped accident, 67 per cent were female. The average age was 30.

Five of the moped riders needing medical attention in the hospital had been passengers on a moped. Of the 27 victims, three sustained injuries serious enough to require hospitalization or transfer to a mainland hospital. None of the victims was an Islander, and all reported wearing a helmet.

Most importantly, Dr. Hirshberg said, nearly all the victims - 90 per cent - required treatment from emergency medical technicians, meaning that an ambulance crew responded to the scene of the accidents and transported them.

"If you had a moped crash, the odds of you using an EMT was very high," said Dr. Hirshberg.

The doctor's study always compares the moped figures to injuries from bicycle and motorcycle accidents. Last year, 134 patients were seen in the emergency room for injuries resulting from bicycle accidents.

Of that number, 45 per cent were female, and the average age was 29. Roughly a third of the victims were Islanders. Less than seven per cent needed hospitalization or transfer to another hospital, and only 28 per cent required an ambulance or EMT involvement. Only 65 per cent of the bike accident victims were wearing a helmet.

In the motorcycle category, 11 people came to the emergency room for help after accidents. They were predominantly men, more than 80 per cent, and almost all of them Islanders, 82 per cent.

They all wore helmets, and only one motorcyclist required hospitalization or transfer. Ambulance response was higher than the bicycle accident data, at 45 per cent. Continuing a trend from last year, Dr. Hirshberg reported seeing more bicycle and motorcycle accident victims who were hurt after attempting some kind of stunt.

As for future studies, Dr. Hirshberg isn't sure whether he will continue to keep such a close tally on two-wheeled accidents and the injuries they caused. It may be time, he said, to investigate other problems on the Island, such as infectious diseases.