Graham Emily M, Frederiksen Hunter, Memmott Stanley, Rioux-Forker Dana, Wang Angela A, Hutchinson Douglas T, Mendenhall Shaun D
Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI.
Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT.
J Hand Surg Glob Online. 2024 Dec 6;7(2):127-134. doi: 10.1016/j.jhsg.2024.10.005. eCollection 2025 Mar.
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.
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.
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.
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.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
包括全地形车（ATV）和多功能地形车（UTV）在内的越野车辆是小儿上肢（UE）创伤的可预防来源。我们假设，与ATV相比，儿童UTV事故导致的UE创伤会伴有更多严重的手部损伤、截肢、手术，以及更长的住院时间和重症监护病房（ICU）住院时间。
使用国际疾病分类第9/10版编码和EPIC布尔逻辑，在一家一级创伤中心识别出2010年至2021年因使用ATV或UTV导致UE损伤的儿科病例。研究结果采用Fisher精确检验、多变量方差分析、事后分析的方差分析以及多元线性回归进行分析。
回顾性研究确定了来自5个州的42名患者（ATV = 25例；UTV = 17例）。儿科UTV骑手发生UE血管损伤的数量是ATV骑手的三倍，手部部分截肢的发生率几乎是ATV骑手的7倍。根据车辆类型，在医院或ICU的住院时间未观察到显著差异；然而，与ATV年轻骑手相比，UTV年轻骑手需要额外进行1.5次重建手术。
UTV导致的事故常常给儿科骑手带来毁灭性的UE损伤。手外科医生处于独特地位，可作为先驱者确保儿科骑手安全，并治疗越野车辆事故造成的毁灭性创伤。
研究类型/证据水平：治疗性IV级。
