More Amputations and Open Fractures: Pediatric Utility Task Vehicle (UTV) Injuries Are More Severe Than All-terrain Vehicle (ATV) Injuries.

Abstract

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.