title: [Quad driving--life-endangering fun? A medical and technical analysis].
abstract: OBJECTIVE
  Quads or all-terrain vehicles do not seem to play a major role either in traffic accidents or in hospital admissions in Germany. However, reports about spectacular quad crashes in the press are not that infrequent. In contrast, no scientific survey or study regarding the issue of quad crashes in Germany has been published so far. Thus, this study aims to evaluate the present incidence of quad crashes, accident circumstances and resulting injury patterns, and to discuss possible consequences.
  
  
  METHODS
  At a level I trauma centre, data from accident and hospital records of quad drivers were analysed focusing on the following parameters: injury type, localisation and mechanism, treatment details, abbreviated injury scale (AIS) score, maximum AIS (MAIS) score, delta-v, collision speed, and other technical parameters. Comparisons to motorcycle accidents were performed. RESULT During a five-year period from 2005 to 2009, there were ten admissions of quad drivers out of around 11 000 emergency trauma patients (0.1 %). Five accidents had happened off-road, four were traffic accidents. Eight patients were male; the mean age was 30 years. The mean total hospital stay was 15 days; there was a mean of 1.5 stays per patients with 2.0 surgical procedures needed. One patient died, only two recovered fully. The accident research data bank revealed 14 cases of quad accidents out of 18 990 (0.1 %). The mean impact velocity was 35 km/h (motorcyclists 40.0 km/h). The most frequent injury mechanism was a collision with a car. The upper extremity was the predominant injured region (AIS 0.7), while it was the lower extremity for motorcyclists (AIS0.91). The maximum AIS were 1.4 in quad drivers and 1.49 in motorcyclists.
  
  
  CONCLUSIONS
  Although the absolute incidence of quad accidents in Germany is low, they pose a relatively high risk for severe injuries. Possible reasons are the comparatively low active and passive safety of quads as well as limited experience with quad driving and the "fun" aspect which might provoke risky driving behaviour. Larger series from the US report a high incidence of drug abuse among quad casualties as well as very limited use of helmets. In Germany, helmet usage has been mandatory since 2006. Possible additional measures to prevent a rise in quad accidents could be the total prohibition of alcohol consumption for quad drivers as well as special courses or driving licenses or an increase of the legal age for driving quads.
authors.affiliation: Unfallchirurgische Klinik, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Straße 1, Hannover. mueller.christian@mh-hannover.de
authors.forename: C W
authors.initials: CW
authors.lastname: Müller
authors.forename: D
authors.initials: D
authors.lastname: Otte
authors.forename: T
authors.initials: T
authors.lastname: Stübig
authors.forename: S
authors.initials: S
authors.lastname: Brand
authors.forename: M
authors.initials: M
authors.lastname: Oszwald
authors.forename: M
authors.initials: M
authors.lastname: Frink
authors.forename: C
authors.initials: C
authors.lastname: Krettek
authors.forename: C
authors.initials: C
authors.lastname: Haasper
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult