title: The continuing problem of all-terrain vehicle injuries in children.
abstract: BACKGROUND
  After the introduction of the all-terrain vehicle (ATV) in the United States in 1971, deaths and injuries in both adults and children rose dramatically. In 1988, the Consumer's Product Safety Commission (CPSC) and all manufacturers of ATVs signed legally binding "Consent Decrees," designed to decrease the number of ATV-related deaths and injuries, especially in children.
  
  
  METHODS
  This report reviews retrospectively the mechanism of injury as well as the injuries in 51 children caused by ATV crashes during a 5-year period after the signing of the decrees.
  
  
  RESULTS
  Data included age; sex; type of ATV (three or four wheel); position of the patient on the vehicle (driver or passenger); helmet usage; and mechanism of vehicular accident, including collision with a stationary or moving object, rollover, or fall from the vehicle. Mechanism data indicate loss of control of vehicle or fall from the vehicle as the most common cause of injury. Injury statistics included body regions and parts injured, injury severity score (ISS), and complications or disabilities resulting from injury. Mean ISS was 13.6 +/- 9.7 (range, 1 to 50). Eighteen patients (35%) had ISSs greater than 15. Helmets were worn by only 30% of patients. There were two deaths, and two patients suffered permanent paralysis. Orthopedic injuries were the most common injury and were of adult type with 61% classified as open or comminuted.
  
  
  CONCLUSIONS
  The magnitude and severity of these injuries argue that this recreational vehicle is exceedingly dangerous for children. The consent decrees have had little effect on reducing the injuries in children from ATVs and should be reevaluated.
authors.affiliation: Benedum Pediatric Trauma Program and the Division of Pediatric Surgery, Children's Hospital of Pittsburgh, Pennsylvania 15213-2583, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Lynch
authors.forename: M J
authors.initials: MJ
authors.lastname: Gardner
authors.forename: J
authors.initials: J
authors.lastname: Worsey
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015541:Off-Road Motor Vehicles / Q000331:legislation & jurisprudence; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology