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Off-Road Vehicle Trauma in Children: A New South Wales Perspective

Soundappan, Soundappan S.V. MBBS, MS(Gen Surg), MCh(Paed Surg), FRACS(Paed)*†; Holland, Andrew BSc, MBBS, FRCS, FRACS(Paed), PhD*†; Lam, Lawrence BSc, MAppPsy, MPH, PhD*†; Roy, Gerard MBBS, FRACS(Paed); Evans, Julie B. Nur GrCert(Emerg Nur), Grad Dip(Mid Wif); Adams, Susan MBBS, FRACS(Paed Surg)§; Cass, Daniel T. MBBS, BSc, FRACS(Paed), PhD*†

doi: 10.1097/PEC.0b013e3181ff0d11
Original Articles

Objective: There is paucity of data on off-road vehicle injuries in children in Australia. We performed a retrospective study from 1998 to 2003 to analyze the frequency and nature of injuries in children involved in off-road vehicle crashes in the state of New South Wales.

Methods: Medical records were identified from search of the trauma database and hospital medical records database for off-road (all-terrain) vehicles.

Results: A total of 271 children were identified, 86% of whom were boys. The mean age was 10 years (range, 2-16 years); and the mean length of stay, 5.8 (9) days (range, 1-40 days). The mean injury severity score was 6 (5.9). Most were drivers (85%). Injury mechanism was falls in 161; collision with stationary object, 54; moving object, 4; rollovers, 7; and others, 8. Eighty-four percent were on 2 wheelers, whereas 11% were quad bikes, and the rest were on tricycles or other vehicles. Distribution of the body region injured was head and neck in 66 patients; face, 51; chest, 25; abdomen, 36; pelvis, 5; spines, 14; upper limbs, 96; and lower limbs, 116. Only 55% were helmeted at the time of the incident. Sixty-five percent of these children required surgical treatment. Most were fractures (98) followed by soft tissue injuries (49). Seventeen had posthead injury sequelae requiring rehabilitation support, and 21 required multiple surgeries. There were 7 deaths during the study period in New South Wales.

Conclusions: Off-road motor vehicle injuries are a significant problem in children. There are no legal safety regulations for use of these vehicles. With the increasing sales of these vehicles, the incidence of injury may rise. There seems a need for education and legislation in relation to the safety issues concerned with these vehicles.

From the Departments of *Academic Surgery, and †Trauma, The Children's Hospital at Westmead, The University of Sydney, Sydney; ‡Department of Pediatric Surgery, John Hunter Children's Hospital, Newcastle, New South Wales; and §Department of Pediatric Surgery, Sydney Children's Hospital, Sydney, Australia.

Reprints: Soundappan S.V. Soundappan, MBBS, MS(Gen Surg), MCh(Paed Surg), FRACS(Paed), Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Locked Bag 4001, Westmead, NSW 2145, Australia (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.