title: Mechanistic relationship of all-terrain vehicles and pediatric renal trauma.
abstract: OBJECTIVE
  To identify and discuss the mechanistic risk factors associated with genitourinary (GU) trauma in pediatric all-terrain vehicle (ATV) accidents.
  
  
  METHODS
  A retrospective analysis of all pediatric trauma admissions to a level 1 trauma center from 2005 to August 2011 was performed. We identified all pediatric patients who presented with GU trauma related to an ATV accident. The demographics, injury data, mechanism of injury, and treatment records of these children were investigated.
  
  
  RESULTS
  A total of 304 pediatric patients were admitted with ATV-related injuries during the study period. Of these 304 patients, 10 (3.2%) had experienced GU injuries. An analysis of the mechanism revealed that 9 of the 10 had been thrown from the ATV; 1 event was described as a rollover accident. All 10 patients sustained renal trauma: 9 renal lacerations of various grades and 1 renal pedicle injury. Hematuria was observed in all cases. Spleen and liver lacerations were commonly associated injuries (40% and 30%, respectively).
  
  
  CONCLUSIONS
  Pediatric ATV-related GU injuries remain an uncommon, yet serious, problem. Renal trauma is the most commonly encountered GU injury and can be suspected by the presence of hematuria. Analysis of the mechanism of injury suggests that ejection from the ATV places pediatric patients at the greatest risk of renal injury. Additional research is recommended concerning the mechanistic relationship of ATV-related GU trauma.
authors.affiliation: Department of Urology, Charleston Area Medical Center, Charleston, West Virginia 25304, USA. nhale@camc.org
authors.forename: Nathan
authors.initials: N
authors.lastname: Hale
authors.forename: Aaron
authors.initials: A
authors.lastname: Brown
mesh_terms: D000059:Accidents; D000293:Adolescent; D002648:Child; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000293:injuries*; D022125:Lacerations / Q000209:etiology; D008297:Male; D015541:Off-Road Motor Vehicles; D012189:Retrospective Studies; D013154:Spleen / Q000293:injuries