Memphis, Tenn. – Children continue to account for a disproportionate percentage of morbidity and mortality from ATV-related accidents – up 240 percent since 1997, according to a Journal of Pediatric Orthopaedics report published by pediatric orthopaedic surgeons at Le Bonheur Children's Hospital.
The surgeons – who studied data from the Kids' Inpatient Database – found spine-related injuries from all-terrain vehicles (ATVs) in the United States are more common in older children and in females, unlike males in most trauma studies. ATV-related spine injuries in children and adolescents are high-energy injuries with a high rate of associated spine and non-spine injuries.
With increases in use and power of ATVs, there have been dramatic increases in both the number and severity of ATV-related injuries. The Kids' Inpatient Database (KID), a national database that is part of the Healthcare Cost and Utilization Project (HCUP), showed a 240 percent increase in the number of children admitted to a hospital for an ATV-related injury between 1997 and 2006. During the same time period, there was a 476 percent increase in the number of children with ATV-related spine injuries.
"We want to encourage physicians to be aware of the potential for associated injuries, including abdominal trauma, thoracic trauma, closed head injury, other spinal fracture, appendicular skeletal fracture, or neurologic injury. Of special interest was the frequency of noncontiguous spinal fracture because a second spinal injury may be missed because it is in a separate region of the spine as the first injury," said Jeffrey R. Sawyer, M.D., Associate Professor, The University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery. Sawyer is a spokesperson on ATV injuries for the American Academy of Orthopaedic Surgeons.
In another study, Sawyer and his colleagues William C. Warner Jr., M.D., Derek Kelly, M.D. reviewed 53 spine injuries in 29 children (1.8 injuries per child) over a five-year span.
The physicians reviewed records and radiographs of children and adolescents who presented to Le Bonheur Children's Hospital in Memphis, Tenn. with injuries from ATV accidents. The children had an average age of 15.7 years; 16 (or 55 percent) had associated nonspine injuries and 13 had multiple spine injuries, contiguous in nine and noncontiguous in four.
Four patients, all younger than age 15, had neurological injuries. Children older than 16 had significantly lower pediatric trauma scores and were more likely to have a thoracic spine fracture than younger children. Younger children were more likely to have a lumbar fracture.
Fourteen patients required surgery for their injuries; seven for spine injuries and seven for nonspine injuries.
This study was the lead article in the July/August 2012 issue of The Journal of Pediatric Orthopaedics. Their conclusions were:
- ATV-related spine injuries in children and adolescents are high-energy injuries with a high rate of associated spine and non-spine injuries.
- ATV-related spine injuries are different from other ATV-related injuries in children in that they are more common in older children and females.
- Musculoskeletal injuries are the most common ATV-related injuries in children; orthopaedic surgeons need to be aware of these differences
- Orthopaedic surgeons should have a high index of suspicion for associated injuries, including additional and often noncontiguous spine injuries.
"Parents need to know that ATVs are not toys but motor vehicles, which can weigh more than 500 pounds. Unlike motor vehicles they lack safety features such as airbags. If you wouldn't let your 12-year-old drive the car then why would you let them operate an ATV? We all too frequently see children unnecessarily severely injured and killed on ATVs," said Sawyer.
About Le Bonheur Children's Hospital
Le Bonheur Children's Hospital in Memphis, Tenn., treats more than 250,000 children each year in a 255-bed hospital that features state-of-the-art technology and family-friendly resources. Nationally recognized, Le Bonheur is ranked by U.S. News & World Report as a Best Children's Hospital. Serving as a primary teaching affiliate for the University Tennessee Health Science Center, the hospital trains more pediatricians than any other hospital in the state. For more information, please call (901) 287-6030 or visit lebonheur.org. Follow us on Twitter at twitter.com/lebonheurchild or like us at Facebook at facebook.com/lebonheurchildrens.
About Campbell Clinic
Founded in 1909, Campbell Clinic serves as a national leader in orthopaedics, sports medicine, teaching and research in orthopaedic surgery. Campbell Clinic has locations in Germantown, Tenn.; Collierville, Tenn.; the Medical District in Memphis, Tenn.; and Southaven, Miss. Campbell Clinic also operates an After Hours Clinic, which is open from 5 to 8 p.m. Monday through Thursday (Germantown and Southaven locations) and Saturday from 8 to 11 a.m. (Germantown location only). For more information on Campbell Clinic, call 901.759.3100 or visit www.campbellclinic.com.
About the University of Tennessee Health Science Center
As the flagship statewide academic health system, the mission of the University of Tennessee Health Science Center (UTHSC) is to bring the benefits of the health sciences to the achievement and maintenance of human health, with a focus on the citizens of Tennessee and the region, by pursuing an integrated program of education, research, clinical care, and public service. Offering a broad range of postgraduate and selected baccalaureate training opportunities, the main UTHSC campus is located in Memphis and includes six colleges: Allied Health Sciences, Dentistry, Graduate Health Sciences, Medicine, Nursing and Pharmacy. UTHSC also educates and trains cohorts of medicine, pharmacy and/or allied health students -- in addition to medical residents and fellows -- at its major sites in Knoxville, Chattanooga and Nashville. Founded in 1911, during its more than 100 years, UT Health Science Center has educated and trained more than 53,000 health care professionals in academic settings and health care facilities across the state. For more information, visit www.uthsc.edu.
Journal
Journal of Pediatric Orthopaedics