Unveiling the Upper-Extremity Morbidities of Utility-Terrain Vehicles in Pediatric Riders

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-03-01 DOI:10.1016/j.jhsg.2024.10.005

Emily M. Graham MD , Hunter Frederiksen MD , Stanley Memmott MD , Dana Rioux-Forker MD , Angela A. Wang MD , Douglas T. Hutchinson MD , Shaun D. Mendenhall MD

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Abstract

Purpose

Off-road vehicles including all-terrain vehicles (ATVs) and utility-terrain vehicles (UTVs) are preventable sources of pediatric upper-extremity (UE) trauma. We hypothesized that UE traumas from UTV accidents in children would be associated with more mutilating hand injuries, amputations, surgeries, and longer hospital and intensive care unit (ICU) admissions compared to ATVs.

Methods

Pediatric cases of UE injury because of the use of an ATV or UTV at a trauma I center were identified using International Classification of Disease 9/10 codes and EPIC Boolean logic from 2010 to 2021. Findings were analyzed with Fisher exact tests, multivariate analysis of variance, analysis of variance with post hoc analyses, and multiple linear regressions.

Results

Retrospective review identified 42 patients from 5 states (ATV = 25; UTV = 17). Pediatric UTV riders had triple the amount of UE vascular compromise and sustained nearly 7-times more partial hand amputations. No significant differences in time spent in the hospital or ICU were observed based on vehicle type; however, young riders of UTVs required 1.5 additional reconstructive surgeries compared to young riders of ATVs.

Conclusion

Accidents caused by UTVs often lead to devastating UE injuries in pediatric riders. Hand surgeons are in a unique position to serve as forerunners to ensure pediatric rider safety and care for the devastating traumas produced by off-road vehicle accidents.