揭示儿童多用途越野车上肢发病率

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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引用次数: 0

摘要

目的越野车包括全地形车（atv）和多功能地形车（utv）是儿童上肢（UE）创伤的可预防的来源。我们假设，与atv相比，儿童UTV事故造成的UE创伤与更多的手部损伤、截肢、手术以及更长时间的住院和重症监护病房（ICU）住院有关。方法采用国际疾病分类9/10编码和EPIC布尔逻辑，对2010 - 2021年创伤1中心因使用ATV或UTV导致UE损伤的儿科病例进行鉴定。研究结果采用Fisher精确检验、多变量方差分析、事后分析方差分析和多元线性回归分析。结果回顾性分析了来自5个州的42例患者(ATV = 25；Utv = 17)。儿科UTV使用者有三倍的UE血管损伤和近7倍的部分手部截肢。不同车辆类型患者在医院或ICU的住院时间无显著差异；然而，与全地形车的年轻骑手相比，utv的年轻骑手需要额外的1.5次重建手术。结论uv引起的意外事故经常导致儿童骑手严重的uu损伤。手外科医生处于一个独特的位置，作为先行者，以确保儿科车手的安全，并照顾越野车事故产生的毁灭性创伤。研究类型/证据水平治疗性IV。

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

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.