Department of Orthopaedics, West Virginia University.
Department of Internal Medicine, Camden Clark Medical Center, Parkersburg, WV.
J Pediatr Orthop. 2023 Sep 1;43(8):e669-e673. doi: 10.1097/BPO.0000000000002447. Epub 2023 Jun 2.
All-terrain vehicles (ATVs) are prevalent in Appalachia and cause significant morbidity and mortality in the pediatric population. This study investigated the injury types and severity in pediatric patients over a 15-year period.
A retrospective chart review was performed on pediatric ATV-related traumas presenting to our institution from 2005 to 2020. Patients were divided into 3 age groups (0-7, 8-12, and 13-17 y) to evaluate differences in accident demographics, hospitalization, Glasgow Coma Scale, Injury Severity Score, substance use, characterization of orthopaedic and nonorthopaedic injuries, and procedures performed.
Inclusion criteria were met by 802 patients. Males represented 71.7% (n=575) and females 28.3% (n=227); the mean age was 12.4 years. The majority (88.5%, n=710) of patients admitted following their accident had a mean stay length of 3.3 days. Of admissions, intensive care unit admission was required by 23.8%, n=191 (mean stay 4.0 d). There were 7 fatalities. The vast majority of accidents occurred between May and September (79.2%, n=635). In patients with documented helmet status, 45% (n=271) were helmeted. Roughly half of all patients (n=393) sustained a fracture (excluding fractures to the head), 370 sustained an injury to the head/face, 129 sustained intra-abdominal/intra-thoracic injuries, and 29 sustained injuries to all 3 systems. The most common fractures involved the forearm (n=98), femur (n=65), and spine (n=59). The most common open fractures were the tibia (n=12), humerus (n=8), and forearm (n=8). The oldest group was more likely than the middle or younger groups to sustain spine ( P <0.0001), pelvis ( P =0.0001), hand ( P =0.0089), and foot ( P =0.0487) fractures. Ethanol testing was positive in 5.0% (n=25) of the oldest group and cannabinoids were present in 6.8% (n=34). The youngest group was significantly more likely to sustain a fracture of the humerus than the middle or older groups ( P <0.0001). Orthopaedic surgical management was required in 24.4% (n=196) of patients.
Pediatric ATV accidents present a significant source of morbidity and mortality. Further intervention is necessary to minimize pediatric ATV injuries.
Level IV-Retrospective Case Series.
全地形车（ATV）在阿巴拉契亚地区很普遍，会给儿科人群造成重大的发病率和死亡率。本研究调查了 15 年来儿科患者的损伤类型和严重程度。
对 2005 年至 2020 年期间我院收治的儿科 ATV 相关创伤患者进行回顾性病历分析。患者分为 3 个年龄组（0-7 岁、8-12 岁和 13-17 岁），以评估事故人口统计学、住院情况、格拉斯哥昏迷评分、损伤严重程度评分、药物使用情况、骨科和非骨科损伤特征以及所进行的操作方面的差异。
符合纳入标准的患者有 802 名。男性占 71.7%（n=575），女性占 28.3%（n=227）；平均年龄为 12.4 岁。大多数（88.5%，n=710）患者在事故发生后住院，平均住院时间为 3.3 天。住院患者中，23.8%（n=191）需要入住重症监护病房（平均住院时间 4.0 天）。有 7 例死亡。绝大多数事故发生在 5 月至 9 月（79.2%，n=635）。在有记录头盔状态的患者中，45%（n=271）戴了头盔。大约一半的患者（n=393）发生骨折（不包括头部骨折），370 例患者发生头部/面部损伤，129 例发生腹部/胸部损伤，29 例患者发生所有 3 个系统的损伤。最常见的骨折涉及前臂（n=98）、股骨（n=65）和脊柱（n=59）。最常见的开放性骨折为胫骨（n=12）、肱骨（n=8）和前臂（n=8）。最年长的组比中组或年轻组更易发生脊柱（ P <0.0001）、骨盆（ P =0.0001）、手（ P =0.0089）和脚（ P =0.0487）骨折。最年长组的乙醇检测阳性率为 5.0%（n=25），大麻素阳性率为 6.8%（n=34）。最年轻组发生肱骨骨折的比例明显高于中组或年长组（ P <0.0001）。24.4%（n=196）的患者需要骨科手术治疗。
儿科 ATV 事故是发病率和死亡率的重要来源。需要进一步干预，以尽量减少儿科 ATV 损伤。
IV 级-回顾性病例系列。
