Kute Blakely, Nyland John A, Roberts Craig S, Hartwick-Barnes Vicki
Department of Orthopaedic Surgery, University of Louisville, KY 40202, USA.
J Pediatr Orthop. 2007 Dec;27(8):851-5. doi: 10.1097/bpo.0b013e31815a60c4.
A database review of 238 admissions for recreational all-terrain vehicle (ATV) accident-related injuries treated over an 11-year period at a level I pediatric trauma center in Central Kentucky was performed.
Descriptive statistical analysis of patient demographics (age and sex), helmet use, county of residence, county of ATV accident, injury mechanism, injuries sustained, days of hospitalization, days in the intensive care unit, Glasgow Coma Scale (GCS) score, Injury Severity Score, Functional Independence Measure (FIM) score, and discharge disposition was performed.
All-terrain vehicle accident-related admissions increased approximately 4.7 times, and overall fracture number increased 4 times over the study period. Most injuries were sustained in the county of residence (81.1% [193 of 238]). The single largest group of patients resided and sustained injuries (48.3% [115 of 238]) in a level I county (metropolitan area population, > or =1 million). Mean Injury Severity Score was 7.3 +/- 5.6, and average hospitalization was 4.3 +/- 4.0 days. Most patients (84% [201 of 238]) were not wearing a helmet, and 18.1% (43 of 238) were admitted to the intensive care unit. Patients were aged 11.4 +/- 3.6 years, predominantly boys (70% [166 of 238]), between the age of 11 and 15 years (59.7% [142 of 238]), and 63% (150 of 238) sustained at least 1 fracture. The lower extremity (32.4% [66 of 204]), upper extremity (25% [51 of 204]), and face-skull (25% [51 of 204]) were the most common fracture sites. The femur (45.5% [30 of 66]) and tibia-fibula (42.4% [28 of 66]) were the most common lower extremity fracture sites. The radius-ulna (39.2% [20 of 51]) and humerus (25% [13 of 51]) were the most common upper extremity fracture sites. Nine patients (4.4% of total fractures) sustained spinal fractures. Most patients (93.7% [223 of 238]) were discharged home, 6.3% (15 of 238) were discharged to a rehabilitation facility or to another hospital. Helmet use was related to higher component GCS and FIM communication scores, and patients with higher component GCS and FIM scores were more likely discharged to home.
Hospital admissions and fractures concurrently increased over the study period, with the greatest increase occurring between 1998 and 1999, shortly after expiration of the 1988 Consent Decrees between the Consumer Product Safety Commission and the ATV industry.
对肯塔基州中部一家一级儿科创伤中心在11年期间收治的238例与休闲全地形车（ATV）事故相关损伤的患者进行了数据库回顾。
对患者人口统计学特征（年龄和性别）、头盔使用情况、居住县、ATV事故发生县、损伤机制、所受损伤、住院天数、重症监护病房天数、格拉斯哥昏迷量表（GCS）评分、损伤严重程度评分、功能独立性测量（FIM）评分及出院处置进行描述性统计分析。
在研究期间，与全地形车事故相关的入院人数增加了约4.7倍，骨折总数增加了4倍。大多数损伤发生在居住县（81.1%[238例中的193例]）。最大的患者群体居住并受伤（48.3%[238例中的115例]）在一级县（大都市地区人口≥100万）。平均损伤严重程度评分为7.3±5.6，平均住院时间为4.3±4.0天。大多数患者（84%[238例中的201例]）未戴头盔，18.1%（238例中的43例）入住重症监护病房。患者年龄为11.4±3.6岁，主要为男孩（70%[238例中的166例]），年龄在11至15岁之间（59.7%[238例中的142例]），63%（238例中的150例）至少有一处骨折。下肢（32.4%[204例中的66例]）、上肢（25%[204例中的51例]）和面部-颅骨（25%[204例中的51例]）是最常见的骨折部位。股骨（45.5%[66例中的30例]）和胫腓骨（42.4%[66例中的28例]）是最常见的下肢骨折部位。桡尺骨（39.2%[51例中的20例]）和肱骨（25%[51例中的13例]）是最常见的上肢骨折部位。9例患者（占骨折总数的4.4%）发生脊柱骨折。大多数患者（93.7%[238例中的223例]）出院回家，6.3%（238例中的15例）出院后前往康复机构或转至其他医院。头盔使用与较高的GCS分项评分和FIM沟通评分相关，GCS分项评分和FIM评分较高的患者更有可能出院回家。
在研究期间，医院入院人数和骨折人数同时增加，最大增幅发生在1998年至1999年之间，即在消费品安全委员会与ATV行业之间的1988年同意令到期后不久。
