Risk factors and musculoskeletal injuries associated with all-terrain vehicle accidents

Accidents, injuries, and deaths sustained via all-terrain vehicle (ATV) use are on the rise. In addition to safe and proper ATV operation, accident-related risk factors include operator controllable behaviors such as helmet use, alcohol use, and deciding whether or not to carry a passenger. What the operator has little or no control over, however, is the inherently unstable ATV design with its narrow wheelbase, short turning radius, and high center of gravity, in addition to common use of low tire pressure to maximize maneuverability. These factors lead to musculoskeletal injuries that consist predominantly of extremity fractures, primarily through rollover events. There is a need for improved ATV operator safety education and more stringent regulations. The purpose of this review is to identify the accident and injury risk factors associated with ATV operation and to compare them with bicycle and motorcycle accident and injury risk factors to enable emergency medical professionals to develop better patient management and injury prevention strategies.