Imaging sheds light on ATV injuries

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CHICAGO, Nov. 26—All-terrain vehicles (ATVs) pose a serious risk of injury and even death, according to large study conducted of ATV injuries in children that used various imaging modalities and presented today at the 93rd annual meeting of the Radiological Society of North America (RSNA).

Chetan C. Shah, MD, radiology fellow at the University of Arkansas for Medical Sciences and Arkansas Children's Hospital in Little Rock, said that that children's use of ATVs is dangerous and should be restricted.

While the American Academy of Pediatrics recommends that children under 16 be prohibited from operating ATVs, no laws are currently in place in most states. According to the Consumer Product Safety Commission, ATV-related injuries in children under 16 more than doubled from 1995 to 2005 with 40,400 children treated in hospital emergency rooms in 2005 in the United States.

The study included 455 consecutive children admitted to Arkansas Children's Hospital following ATV accidents. The children ranged in age from six months to 19 years (with a mean age 11.4 years), including 318 boys and 137 girls.

Head injuries detected by CT or MRI included: skull fractures 77, extra axial hemorrhage 62 and brain injuries 53. Lung injuries were present in 36 children, while spleen, liver, kidneys or pancreas injuries were found in 70 children. Extremity fractures occurred in 208 children with broken legs being the most common. There were 12 amputations, including nine partial foot amputations, one upper limb amputation and one below-knee amputation. There were six fatalities and several cases of long-term disabilities. The fatalities represent only the children who died at the hospital, not those who died at the accident site.

The researchers concluded that head, torso and extremity injuries are common in children suffering ATV injuries. Cranial and orbit fractures are associated with brain injuries and extra axial hemorrhage. Torso injuries frequently involve multiple organs. Extremity fractures are the most common radiographic detected injuries & lower extremity fractures are associated with long term disability.

The researchers also said that the study is the largest series of imaging findings in children suffering ATV injuries, which shows the spectrum of potential injuries.

S.T. Bhutta, MD, S. Greenberg, MD, and D.N. Parnell-Beasley, MSc, are co-authors of the study.