Jaggers Bliss C, Krinock Derek J, Le Ngoc M, Nolte Jack A, Wyrick Deidre L, Schoenleber Scott J
School of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Department of Surgery, Division of Pediatric Surgery, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Little Rock, AR.
J Pediatr Orthop. 2025 Aug 1. doi: 10.1097/BPO.0000000000003068.
Utility task vehicles (UTVs) differ from all-terrain vehicles (ATVs) in that they are heavier, have larger engines, and have rollover protective structures. Despite their growing popularity for recreational use, there is emerging evidence that mutilating injuries may be higher in UTVs than ATVs, but this has not been evaluated in a pediatric-only population. This study seeks to determine differences in injury characteristics between vehicle types.
A retrospective cohort study was performed at a level 1 pediatric trauma center, evaluating all patients <18 years old who presented following an ATV or UTV accident between 2018 and 2023. Demographic, injury and outcomes data was collected. Statistical analysis was performed with a combination of the Student t test for continuous data and the Fisher exact or χ2 tests for categorical data.
A total of 743 patients were identified (ATV 533, UTV 210), with a mean age of 11.8±3.7 y, with ATV patients being older (12.1±3.6 y) than UTV patients (11.2±4.0 y, P=0.003). Overall rates of admission (ATV 54% vs. UTV 60%; P=0.12), surgical treatment (ATV 42% vs. UTV 43%; P=0.87), and readmission (ATV 6% vs. UTV 5%; P=0.86) were similar between groups. UTV injuries resulted in significantly more open extremity fractures (ATV 6.6% vs. UTV 11%; P=0.045), more type IIIa/b/c open fractures (ATV=1.7%, UTV=6.2%; P=0.001), and more amputations (ATV 0.4% vs. UTV 3.3%; P=0.0009). Amputation level was transhumeral or through-elbow in 3 patients (all UTV), transtibial in 1 patient (UTV), multiple fingers in 1 patient (UTV), and single partial finger in 4 patients (2 UTV, 2 ATV).
UTV injuries have a higher rate of amputation, open fracture, and severe open fracture compared with ATV injuries. Significant amputations (major limb or multiple fingers) were observed only in the UTV group. Surgeons and the general public should be aware that UTVs have the potential for more severe trauma to the limb, potentially resulting in loss of limb function.
Level III-retrospective cohort.
多功能任务车（UTV）与全地形车（ATV）不同，UTV更重，发动机更大，且有翻车保护结构。尽管UTV在娱乐用途中越来越受欢迎，但有新证据表明，UTV造成的肢体毁损性损伤可能比ATV更高，但这尚未在仅针对儿科人群的研究中得到评估。本研究旨在确定不同类型车辆损伤特征的差异。
在一家一级儿科创伤中心进行了一项回顾性队列研究，评估了2018年至2023年间因ATV或UTV事故就诊的所有18岁以下患者。收集了人口统计学、损伤和结局数据。对连续数据采用Student t检验，对分类数据采用Fisher精确检验或χ2检验进行统计分析。
共纳入743例患者（ATV 533例，UTV 210例），平均年龄11.8±3.7岁，ATV患者年龄（12.1±3.6岁）大于UTV患者（11.2±4.0岁，P=0.003）。两组的总体入院率（ATV 54% vs. UTV 60%；P=0.12）、手术治疗率（ATV 42% vs. UTV 43%；P=0.87）和再入院率（ATV 6% vs. UTV 5%；P=0.86）相似。UTV损伤导致更多的开放性四肢骨折（ATV 6.6% vs. UTV 11%；P=0.045）、更多的IIIa/b/c型开放性骨折（ATV=1.7%，UTV=6.2%；P=0.001）和更多的截肢（ATV 0.4% vs. UTV 3.3%；P=0.0009）。截肢水平为经肱骨或经肘的有3例患者（均为UTV），经胫骨的有1例患者（UTV），多手指的有1例患者（UTV），单部分手指的有4例患者（2例UTV，2例ATV）。
与ATV损伤相比，UTV损伤导致截肢、开放性骨折和严重开放性骨折的发生率更高。仅在UTV组观察到严重截肢（主要肢体或多手指）。外科医生和公众应意识到，UTV有导致更严重肢体创伤的可能性，可能导致肢体功能丧失。
III级——回顾性队列研究。
