Summer is now in full swing, and with the heat rising, we are seeing an increase in typical summertime orthopedic injuries in children. Dr. Tyler Christman, orthopedic surgeon at Riley Hospital for Children at IU Health, reviews what parents need to keep in mind when participating in certain activities.
What are the most common culprits of serious summertime injuries for kids?
Active outdoor play is certainly encouraged as part of a healthy lifestyle, and accidents are bound to happen. However, some outdoor activities are simply too dangerous for kids. Identifying activities that are particularly dangerous and limiting your child’s exposure to these activities may ultimately prevent a potentially life-threatening accident or fatality.
The injuries resulting from ATV and lawn mower accidents can be devastating and can result in long-term disability or limitations. In addition to the physical trauma experienced by the patient, many families of children involved in these types of accidents often report significant emotional burden and self-blame, as the injuries often occur when the child is riding with an older sibling or parent.
The safest practice for children is to stay out of the yard or play inside during lawn mowing activity. Children should never ride on or be pulled from mowers when the grass is being cut.
Limiting exposure and knowing the risks involved with ATVs and related equipment (UTVs, dune buggies, go-karts and dirt bikes) is an important part of reducing related injury.
How widespread is the problem?
In a report released in January of 2017, the Consumer Product Safety Commission estimates that during 2015, there were 97,200 ATV-related, emergency department-treated injuries in the United States. They estimate that almost one-third of these injuries involved children younger than 16 years of age. Roughly half of those patients were younger than 12 years old.
From 2013-2015 there were 1,438 reported ATV-related fatalities in the United States, 28 of those occurring in Indiana. It is estimated that 22 percent of these fatalities occurred in children younger than 16 years of age. More children are killed in the United States each year from ATV accidents than from bicycle crashes.
Unfortunately, at Riley Hospital for Children at IU Health, our numbers mirror national trends with approximately 165 ATV injury patients treated from 2012-2016. Already this season, there have been several children in Indiana who have sustained serious head trauma from ATV crashes when a helmet was not worn.
What is the danger for children?
Children ATV riders are at 12 times greater risk of injury compared to adult riders. There was a 150 percent increase in ATV-related injuries from 1997-2006 with the largest increase in children between ages 15 and 17 years of age.
Potential injuries from ATV accidents include relatively minor injuries such as bruising, abrasions, lacerations, strain/sprains, to more serious injuries such as internal organ damage, fractures and traumatic brain injuries. Most injuries occur to the head/neck and arms, followed by the torso and lower extremities.
Orthopedic-specific injuries typically consist of both high- and low-energy fractures to the pelvis and extremities. Complex injuries often include open fractures or those complicated by bleeding, nerve damage or soft tissue injuries.
What are some of the misconceptions about the safety of ATVs?
One of the largest misconceptions regarding the safety of ATVs is that it is safe for a child to ride with an adult.
Multiple riders on an ATV designed for a single rider is unsafe for several reasons. Passengers can distract the driver, alter the center of gravity of the vehicle increasing roll-over risk, and interfere with steering. Passengers have a greater risk for being ejected during an accident.
It is has been reported that 95 percent of youth who have been injured on ATVs were riding or operating an adult-sized ATV. Generally speaking, larger ATVs are more dangerous to younger riders.
It has been shown that patients injured on an ATV with an engine size greater than 350cc are more likely to have sustained a traumatic brain injury. The ATV Safety Institute recommends limiting engine size to less than 70cc for children 6-9 years of age and less than 90cc for children younger than 15 years old.
What is the most important thing parents should know to keep their children safe?
Recommendations from the ATV Safety Institute’s include:
n Always wear a helmet and other protective gear.
nNever ride on public roads — another vehicle could hit you.
nNever ride under the influence of alcohol or other drugs.
nNever carry a passenger on a single-rider vehicle.
nRide an ATV that’s the right size for your age.
nSupervise riders that are younger than 16; ATVs are not toys.
nRide only on designated trails and at a safe speed.
nTake an ATV RiderCourse.
Explain how Indiana’s new helmet law will protect our youngest.
As of July 1, Indiana requires children under age 18 to wear helmets while riding or operating an off-road vehicle. Owners of off-road vehicles who allow children to ride ATVs on public or private land without wearing a helmet that meets federal safety standards could face a Class C infraction and up to $500 penalty.
Helmets are estimated to reduce the risk of fatal ATV-related head injuries by 40 percent and non-fatal injuries by 60 percent or more. Indiana’s new helmet law is a step in the right direction. We hope that as more people learn about these new regulations, it will encourage them seek more education on how to enjoy this activity as safely as possible.
