Motocross morbidity: economic cost and injury distribution in children.

BACKGROUND

Motocross is a nationally organized sport that is growing in popularity. The distribution and severity of motocross injuries in the pediatric population is not known. We hypothesize a high rate of musculoskeletal injuries requiring hospitalization and/or surgical intervention.

METHODS

All patients 17 years of age or younger with injuries sustained while using off-road 2-wheeled motorcycles were identified through surgical, diagnostic, and trauma registries at a level 1 regional trauma center. Type, severity, and mechanism of injury were assessed, as well as charges billed for medical care. Both recreational and competitive motocross activities were included.

RESULTS

From 2000 to 2007, 299 cases were noted in 249 unique patients. In 141 instances, hospital admission was required, for a total of 412 inpatient days. Twenty patients required ICU admission. Surgery was performed in 91 cases (81 orthopaedic, 6 general, 1 urology, and 4 facial reconstructions). Orthopaedic surgical procedures included treatment of 29 femur fractures, 8 forearm, 6 ankle, 5 tibial shaft, 6 proximal tibia, 5 spine, 6 proximal humerus, 4 hand, 4 foot, 3 elbow fractures, and 5 other. Orthopaedic interventions also included 8 reductions under general anesthesia and 31 conscious sedations. Mean age at injury was 14.1 years (range: 5.4 to 17.9). Ninety-four percent of patients were male and 85% were White. The majority of patients were wearing helmets/safety equipment. One hundred and eighty-four injuries occurred on a track, with 150 during competition. The mean charge billed per injury was $14,947 (range: $105 to $217,780), with a total cost of $4.5 million.

CONCLUSIONS

Nearly half of motocross patients treated at a regional level 1 trauma center required hospitalization, and nearly one-third required surgery. The vast majority of surgical procedures (89%) were orthopaedic. Despite a high usage rate of helmets and protective gear, severe injuries were still sustained, including femur fracture (29), hemiparesis/spinal cord injury (2), and head injury (43). The majority of injuries occurred during organized race or practice. Families should be counseled with regard to the use of safety equipment and the severity of injuries sustained during competitive motocross activity.

LEVEL OF EVIDENCE

Level IV, case series.