All-Terrain Vehicle–Related Maxillofacial Trauma in the Pediatric Population
Purpose
Nearly 40% of all-terrain vehicle (ATV) crash-related fatalities involve pediatric patients, with many of these patients dying from head and neck injuries. West Virginia is in a unique position to examine these injuries because of its high rate of ATV use. This study examines craniofacial ATV-related trauma in children.
Patients and Methods
We conducted a single-center, retrospective, descriptive study of 26 children presenting with a craniofacial injury(ies) resulting from an ATV crash from January 2001 to December 2004.
Results
Twenty-six children (65% boys) with a mean age of 13.1 years presented with craniofacial injuries during the study period. Two patients were helmeted. Mortality was 3.8% (n = 1, head injury related, postinjury day 3). Patients were most often drivers of the ATV (65%), although girls were more likely to be passengers (P = .03). Facial contusions, lacerations, and abrasions were highly prevalent (62%, 69%, 65%, respectively), as were fractures of the facial bones and skull (77%). Thirty-five percent sustained closed head injuries, which were significantly associated with mandible fractures (odds ratio 12.8%; 95% CI, 1.15-143). Mean length of hospital stay was 4.6 ± 5 days, and 36% required an ICU stay (mean, 5.1 ± 3 days). Twenty-four percent required ventilator support (mean, 107 ± 43 hours; range, 48 to 168 hours). Operative intervention was required in 72% of patients (n = 18).
Conclusion
Maxillofacial injury patterns from ATV-related crashes in children suggest a high percentage of significant facial injuries and closed head injuries. As new ATV legislation that addresses operator use is enacted, a decrease in the number and severity of craniofacial injuries may be seen.
⁎General Surgery Resident–PGY 3, Department of Surgery, West Virginia University School of Medicine–Charleston Division, Charleston, WV.
†Attending Surgeon, Section of Maxillofacial Surgery, Department of Surgery, Charleston Area Medical Center, Charleston, WV.
‡Research Assistant, Charleston Area Medical Center Health Education & Research Institute, Charleston, WV.
§Attending Surgeon, Section of Maxillofacial Surgery, Department of Surgery, Charleston Area Medical Center, Charleston, WV.
∥Medical Student, West Virginia University School of Medicine–Charleston Division, Charleston, WV.
¶Medical Student, West Virginia University School of Medicine–Charleston Division, Charleston, WV.
#Medical Student, West Virginia University School of Medicine–Charleston Division, Charleston, WV.
⁎⁎Medical Student, West Virginia University School of Medicine–Charleston Division, Charleston, WV.
Address correspondence and reprint requests to Ms Flaherty: CAMC Institute, 3211 MacCorkle Ave SE, Charleston, WV 25304
ABSTRACT