Pediatric Upper Extremity Trauma Secondary to All-terrain Vehicle Use.

All-terrain vehicles (ATVs) have become popular with respect to recreational activities. Multiple orthopaedic and pediatric organizations currently recommend limiting use of ATVs to older age groups of children with supervision. These recommendations have not generally been adhered to, resulting in a disproportionate number of pediatric orthopaedic trauma, specifically of the upper extremities. A retrospective review of patients 18-years-old and younger who presented to a single, Level I Trauma Center with ATV-related upper extremity trauma between 1996 and 2006 was undertaken to determine the impact of ATV use on the upper extremities of children. A total of 65 patients were identified with an average age of 12.3. Only 29.2% wore helmets and 73.8% were drivers. The hand and elbow were the most common injury sites in patients under age 12, elbow for those between ages 12 and 16, and wrist for those over age 16 (p = 0.031). Fractures/Dislocations were the most common injury in all age groups (p = 0.0077). The most performed surgical procedure was open reduction internal fixation of fractures, and patients required an average of 4.8 total operations. Patients who had non-isolated upper extremity injuries were associated with longer hospital stays (p = 0.011) but not ICU stays (p = 0.10). In order to reduce pediatric upper extremity injuries from ATVs, restrictions must be more stringent and safety education made a priority. (Journal of Surgical Orthopaedic Advances 32(2):088-091, 2023).