We sought to evaluate the frequency and distribution of
maxillofacial injuries associated with all-terrain vehicle (ATV) collisions and to compare this with patients involved in motorcycle accidents over the same 5-year period at the University of Alabama at Birmingham. Patients and methods The records of all patients involved in ATV collisions who were admitted to the University of Alabama at Birmingham Trauma Center from January 1998 to January 2003 were reviewed. Age, gender, mechanism of injury,
length of stay, Glasgow Coma Scale (GCS) score,
maxillofacial injuries, Injury Severity Score (ISS), and maxillofacial Abbreviated Injury Scale (AIS) score were the factors considered for the study. These variables were also analyzed for patients involved in motorcycle collisions who sustained maxillofacial
trauma.
RESULTS: There were a total of 72 ATV collisions; 23 patients (32%) sustained
maxillofacial injuries. The mean age was 31, and there were 59 males (82%) and 13 females (18%). The most common mechanism of injury was an ATV rollover. The warmer seasons and weekend days had the highest frequency of ATV
trauma. Of the 23 patients who sustained
maxillofacial injuries, the average maxillofacial AIS score was 2. The
length of stay and GCS score were 8 days and 12, respectively, compared to 5 days and 15 in the nonmaxillofacial injury group. The most common maxillofacial fracture seen was a zygomaticomaxillary complex fracture (n = 8), followed by
mandibular fractures (n = 6), and orbital floor blowout fractures (n = 5). Eighty-three percent of patients with
maxillofacial injuries required an operative intervention during their hospitalization. The distribution of maxillofacial fractures in the ATV group was similar to that of an equivalent motorcycle group, but the frequency for the ATV group was higher (32% versus 8%). The
length of stay for the motorcycle group was 11 days versus 8 days for the ATV group. The GCS scores, maxillofacial AIS scores, and ISS were similar between the 2 groups (12, 2, and 18, respectively). In patients who sustained maxillofacial fractures, neurologic
injuries were the most frequent concomitant injury in the ATV group, whereas orthopedic
injuries occurred more often in the motorcycle group.
CONCLUSIONS:
Maxillofacial injuries are common findings in ATV collisions. ATV patients with maxillofacial fractures have more neurologic impairment at admission and longer hospitalizations than patients sustaining motorcycle
injuries. There needs to be an increase in the public health effort to educate individuals about the dangers of ATVs and to provide proper safety guidelines before the purchase of a vehicle.