All-terrain vehicles (ATVs) were introduced in this country in the 1970s. Currently, there are approximately 9.5 million ATVs in use and more than 150,000 reported ATV-related injuries in this country annually. The rapid rise in ATV-related injuries is due to increased use and also to the production of larger, faster, and more powerful vehicles, according to a review article that was recently published in the April issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

“Most accidents are rollovers, when the vehicle tips over and crushes the rider,” said orthopaedic surgeon and lead author Jeffrey R. Sawyer, MD. “Children, because of their low weight and strength, are unable to correct the rollover and get crushed.”

The fact that rollovers are the most common cause of injury helps to explain why many children involved in ATV accidents suffer lower extremity fractures, because the leg is often pinned beneath the vehicle. “Other injuries unique to ATV accidents include partial or complete foot amputations, usually secondary to the foot being caught in the chain, and clothesline-type injuries to the head and neck that occur when the rider strikes a clothesline or fence,” according to the article.

Although only 15 percent of ATV riders are children, children account for approximately 27 percent of ATV-related injuries and 28 percent of ATV-related deaths. In addition to being unable to correct a rollover, children also may take more risks than older drivers.

“The incidence and severity of injuries has increased dramatically during the past 10 years, and most of these injuries are preventable. Unfortunately, there is a high prevalence of life-threatening injuries, such as head injuries, abdominal injuries, and thoracic injuries. In addition, there is a large public health cost that is not only in terms financial, but in productive life-years lost. In other words, this is a problem that affects young people with many productive years ahead of them,” Dr. Sawyer added.

Important findings from the review article include the following:

* Orthopaedic injuries are the most commonly reported injuries in ATV accidents.

* Caucasian males between the ages of 18 and 30 who live in rural areas are the group most frequently injured in ATV-related accidents.

* In 80 percent of accidents, they are the drivers rather than the passengers.

* The number of ATVs in use increased from 400,000 in 1985 to more than 9.5 million in 2007.

* Between 1982 and 2008, there were 9,633 reported ATV-related deaths, and 2,588 (27 percent) were in children younger than 16 years old.

* The number of reported ATV-related deaths per year increased from 29 deaths in 1982 to 221 in 1992 to 699 in 2007.

* All 50 states reported ATV deaths between 1982 and 2008, with the highest numbers occurring in California (516), West Virginia (473), Pennsylvania (468), and Texas (460).

* The number of reported ATV-related injuries per year increased from 10,100 in 1982 to 58,200 in 1992 to more than 150,000 by 2007.

* In 2007, 27 percent of injuries occurred in children younger than 16 years old.

Modern ATVs are classified as either sport vehicles or utility vehicles. Sport vehicles are typically light two-wheel-drive vehicles that accelerate quickly, while utility vehicles are larger, four-wheel-drive vehicles designed for off-road use. Additionally, there are a variety of smaller vehicles designed for children.

“Children are going to ride ATVs, so they need to do it safely. These are motor vehicles, not toys, and parents should use the same guidelines they would when allowing their children to drive cars. For example, you would not let your 10-year-old drive a car, so why would you let him or her drive an ATV that can weigh hundreds of pounds and go up to 100 mph? The most important ways to prevent injury are adult supervision, helmets, protective clothing and age-appropriate vehicles,” Dr. Sawyer added.