From the DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine (R.R.), Miami, Florida; Department of Surgery, New York University Winthrop (D.K.J.), Mineola, New York; Department of Surgery, Emory University School of Medicine (C.J.D.), Atlanta, Georgia; Department of Surgery, Hofstra University Zucker School of Medicine (E.N.K.), East Garden, New York; Department of Surgery, University of Arkansas for Medical Sciences (M.K.K.), Little Rock, Arkansas; Department of Surgery, Morehouse School of Medicine (J.N.), Atlanta, Georgia; Department of Surgery, University of South Alabama School of Medicine (J.D.S.), Mobile, Alabama; Department of Surgery, University of Arizona (T.O.), Tucson, Arizona; and Department of Surgery, University of Florida College of Medicine Jacksonville (M.C.), Jacksonville, Florida.
J Trauma Acute Care Surg. 2018 Jun;84(6):1017-1026. doi: 10.1097/TA.0000000000001828.
Despite increasing usage since their introduction, there exist no evidence-based guidelines on all-terrain vehicles (ATVs) and injury prevention. While the power and speed of these vehicles has increased over time, advancements in ATV safety have been rare.
A priori questions about ATV injury pattern and the effect of helmet and safety equipment use and legislation mandating use were developed. A query of MEDLINE, PubMed, Cochrane Library, and Embase for all-terrain vehicle injury was performed. Letters to the editor, case reports, book chapters, and review articles were excluded. Grading of Recommendations Assessment, Development, and Evaluation methodology was used to perform a systematic review and create recommendations.
Twenty-eight studies were included. Helmet use reduced traumatic brain injury (TBI). However, studies examining whether legislation mandating helmet use reduced TBI had mixed results. When ATV safety legislation was enforced, overall injury rates and mortality decreased. However, enforcement varied widely and lack of enforcement led to decreased compliance with legislation and mixed results. There was not enough evidence to determine the effectiveness of non-helmet-protective equipment.
Helmet use when riding an ATV reduced the rate of TBI. ATV safety legislation, when enforced, also reduced morbidity and mortality. Compliance with laws is often low, however, possibly due to poor enforcement. We recommend helmet use when riding on an ATV to reduce TBI. We conditionally recommend implementing ATV safety legislation as a means to reduce ATV injuries, noting that enforcement must go hand in hand with enactment to ensure compliance.
尽管自推出以来使用量不断增加，但针对全地形车（ATV）和伤害预防，尚无基于证据的指南。随着这些车辆的功率和速度不断提高，ATV 安全方面的进步却很少。
预先提出了有关 ATV 伤害模式以及头盔和安全设备使用效果以及立法强制使用的问题。对 MEDLINE、PubMed、Cochrane 图书馆和 Embase 进行了 ATV 伤害的查询。排除了社论、病例报告、书籍章节和评论文章。使用推荐评估、制定和评估方法（Grading of Recommendations Assessment, Development, and Evaluation，GRADE）进行系统评价并提出建议。
共纳入了 28 项研究。头盔的使用减少了创伤性脑损伤（TBI）。但是，研究头盔使用立法是否减少 TBI 的结果喜忧参半。当执行 ATV 安全法规时，整体受伤率和死亡率下降。但是，执法差异很大，缺乏执法导致对立法的遵守程度降低，结果也不一致。没有足够的证据来确定非头盔保护设备的有效性。
骑 ATV 时戴头盔可降低 TBI 的发生率。当执行 ATV 安全法规时，也可降低发病率和死亡率。但是，法律的遵守程度往往较低，这可能是由于执法不力。我们建议在骑 ATV 时使用头盔以减少 TBI。我们有条件地建议实施 ATV 安全法规，以减少 ATV 伤害，同时注意必须将执法与法规的制定结合起来，以确保遵守法规。
