Off-road vehicle upper extremity injuries: Estimated incidence and trends in the United States from 2014 to 2024.

Abstract

Amid the emerging popularity of recreational vehicles, there has been a subsequent increase in off-road vehicle injuries. The purpose of this study was to delineate trends in the incidence and volume of upper extremity injuries caused by all-terrain vehicles (ATVs), utility task vehicles (UTVs), and dune buggies in the United States and to bring awareness to these trends to guide the development of safety measures and modifications. The National Electronic Injury Surveillance System (NEISS) Database was queried for ATV, UTV, and dune buggy injuries between 2014 and 2024 for upper extremity injuries. Demographic data, diagnosis, injury type and location, descriptions of the accidents, and patient dispositions were accrued from the emergency department encounters collected in this database. There were an estimated 319,403 cases of off-road vehicle injuries involving the upper extremity in the study period, most of which involved ATVs specifically. The volume of off-road vehicle injuries overall increased from 2014 to 2024, with approximately 105,796 injuries in 2014 and 111,613 injuries in 2024. Fractures were the most common type of injury, accounting for 47% of encounters. The greatest number of injuries in 2014 (10,361) and 2024 (8256) were among the 10- to 19-year-old cohort. There was a 10% decrease in upper extremity injuries from 2014 to 2024, with peaks in 2016 and 2020. Shoulder injuries accounted for the most common upper extremity injury among ATV (33%), UTV (25%), and dune buggy drivers (29%). Fractures were the most common type of injury, and shoulders were the most prevalent injured upper extremity. Despite an overall decline in prevalence, off-road vehicle injuries pose a threat to adolescent safety, and there remains a need for increased safety measures, vehicle modifications, and protective legislation involving off-road vehicle use. IV.