Neurologic injuries associated with all-terrain vehicles and recommendations for protective measures for the pediatric population.

Objective: To present data and case studies illustrating the danger, especially in the pediatric population, of all-terrain vehicle (ATV) use, and to provide recommendations for pediatricians on how to educate parents concerning ATVs.

Design: Retrospective review of 33 patients with neurologic injuries sustained in ATV accidents presenting to one institution over a 40-month period.

Setting: Emergency department and neurosurgery service at Arkansas Children's Hospital and two other hospitals that make up the University of Arkansas for Medical Sciences.

Patients: All patients (n = 33) who presented between January 1993 and April 1996 at the emergency departments with neurologic injuries sustained in accidents involving either a three- or four-wheel ATV requiring hospitalization.

Interventions: Depending on the nature of the injury, various treatments, as described herein.

Main Outcome Measures: Demographic measures, the mechanisms of injury, the types of injuries; the current data available regarding the number of injuries nationwide; and the precautionary measures parents should be advised to take.

Results: Ages ranged from four to 68 years (mean, 18; median, 14), 21 of the patients were < 16 years old. The predominant age range was 12 to 15 years; most common mechanisms of injury were being thrown to the ground, striking a tree, and flipping backward. Most injuries were cranial (21) or spinal (11). Nationwide, the proportionate number of injuries are decreasing, but the consequences remain severe. Using a helmet and restricting the use of these vehicles will reduce the number and magnitude of injuries.

Conclusions: Although perceived as recreational toys, ATVs can be extremely unsafe, especially for children and adolescents; pediatricians should educate parents and patients on the dangers of riding these vehicles.