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All-Terrain Vehicle - Related Maxillofacial Injuries Presenting to the Emergency Department: A 10-Year Analysis of
Michael Megafu1, Isabelle Finzen2, Laura Mackrides2
1Resident, Department of Orthopaedic Surgery, University of Connecticut, Farmington, CT.
Background:
All-terrain vehicle (ATV)-related injuries are a significant source of morbidity in the United States, particularly among children and young adults. Despite the frequency of facial trauma associated with ATV use, national epidemiologic data on maxillofacial injuries remain limited.
Purpose:
The purpose of this study was to evaluate national trends in ATV-related maxillofacial injuries presenting to U.S. emergency departments from 2014 to 2023.
Study Design, Setting, Sample:
A retrospective cohort study was performed using the National Electronic Injury Surveillance System database. Patients presenting with ATV-related injuries involving the head, face, mouth, or eye between January 1, 2014, and December 31, 2023, were included. Cases involving non-ATV vehicles, injuries outside the maxillofacial region, or miscoded narratives were excluded.
Predictor Variable:
The independent variable was the year of emergency department presentation.
Main Outcome Variables:
The outcome variables were national estimates of ATV-related maxillofacial injuries, injury diagnosis (eg, fracture, laceration, concussion), and anatomic location (head, face, mouth, and eye).
Covariates:
The covariates were age, sex, race, diagnosis category, and injured body region.
Analyses:
Descriptive statistics characterized the study population. National estimates were generated using National Electronic Injury Surveillance sample weights. Linear regression was used to assess temporal trends in annual injury rates and fracture incidence. Statistical significance was defined as P < .05.
Results:
A total of 7,318 cases were identified, representing an estimated 314,982 ATV-related maxillofacial injuries nationwide. Injuries occurred predominantly in male subjects (67.2%) and White subjects (57.8%), with a mean age of 26.0 ± 20.9 years. The head (64.7%) and face (29.4%) were the most commonly injured regions. Internal injuries (32.5%) and fractures (14.3%) were the most frequent diagnoses. Although the overall injury rate remained stable during the study period, facial fracture incidence increased statistically significantly over time (P = .04; b = 430.2; 95% CI, 37 to 897.4).
Conclusion:
ATV-related maxillofacial injuries remain a substantial public health concern. While overall injury rates were unchanged, facial fractures increased statistically significantly from 2014 to 2023. These findings highlight the need for strengthened injury prevention efforts, including helmet use, age restrictions, and public safety initiatives, while emphasizing the importance of surgical preparedness for managing complex ATV-related facial trauma.
