Foot injuries associated with all-terrain vehicle use in children and adolescents

Objectives: Children can suffer serious foot injuries while riding or driving an all-terrain vehicle (ATV). The purpose of this study was to describe this injury pattern. Methods: A search of the trauma registry of the Arkansas Children's Hospital for the years 1998 through 2006 was conducted to find cases of children admitted for treatment of foot injuries related to ATV use. The cases were deidentified and summarized. The study was reviewed and deemed to be exempt by the local institutional review board. Results: Ten cases of foot injury were identified. The median age was 3 years. Eight had forefoot injuries, including 6 who had amputation of the great toe. All but one patient had multiple open foot fractures. Seven required skin grafting. Complications included infection, scar formation, disfigurement, and gait disturbance. The mean length of stay on initial hospitalization was 6 days, and the mean hospital charge was $12,890. Conclusions: Children, particularly young children, on an ATV can suffer serious foot injuries resulting in disfigurement and disability. The recommendation that young children not, ride on ATVs is emphasized by these findings.