Upper extremity injuries associated with all terrain vehicle accidents: A multicenter experience and case review.

Background: All terrain vehicle accidents are a common cause of trauma admission and often associated with extremity injuries. However specifics of injury patterns to the upper extremity has not previously been described. A multicenter, retrospective study was conducted to determine the frequency and distribution of upper extremity injuries sustained from ATV accidents.

Methods: Medical records of all patients presenting to two trauma centers with ATV related upper extremity trauma from 2001 to 2013 were reviewed. Patient records and radiographic data were analyzed for detailed extremity injury data. The identified injuries were classified by: anatomic location (shoulder, arm, elbow, forearm, wrist, hand) and structures involved (fracture/dislocation, amputation, nerve, artery, soft tissue). In addition, patient demographic information, length of stay (LOS), airway status, intensive care unit (ICU) stay, Glasgow coma scale (GCS), use of safety equipment, and associated injuries RESULTS: Two hundred seventy-seven patients with upper extremity injuries secondary to ATV accidents presented from 2001 to 2013. The frequency and distribution of ATV related upper extremity injuries classified by anatomic location demonstrated 18% of injuries involving the shoulder, 20% arm, 16% elbow, 18% forearm, 40% wrist, and 24% hand, with 30% of patients having injuries that involved more than one anatomic location. Injuries classified by structure involved indicated 73% of injuries were fracture/dislocations, 4% nerve injury, 2% vascular injury, and 36% soft tissue injury.

Conclusion: The most common upper extremity injuries experienced in ATV injuries were fractures/dislocations with one third of patients having injuries that involved more than one anatomical location. Less than half of the patients were documented as having worn safety equipment, illustrating a need for increased awareness and enacted of measures to improve safety and prevent accidents.