Snowmobile injuries in children and adolescents

OBJECTIVE: To characterise the risk factors and patterns of injury for children involved in snowmobile incidents. PATIENTS AND METHODS: We reviewed the medical records of patients younger than 18 years who required hospital admission for snowmobile-related incidents from 1992 to 2001. Information obtained from these records and from the trauma database included patient demographics, mechanism of injury, injury patterns, medical care, and outcomes. RESULTS: Forty-three patients were admitted to our hospital for snowmobile-related incidents. Snowmobile incidents occurred most commonly in male adolescents. The 2 most common mechanisms of injury were ejection and striking a stationary object. Twenty-seven (63%) of the patients drove the snowmobile. Only 23 patients (53%) wore a helmet. At presentation, the mean ± SEM Injury Severity Score (ISS) was 12.1±1.4. Orthopedic injuries predominated (n=42); however, abdominal (n=12) and head (n=8) injuries were also common. Four patients were intubated, and 15 required intensive care unit admission. Twenty-nine patients (67%) required surgical intervention. The mean ± SEM length of hospitalisation was 6.7±1.4 days. No deaths occurred; however, 7 patients (16%) had long-term disabilities. A significant improvement occurred in both Glasgow Coma Scale (GCS) score and ISS for patients using a helmet. In addition, helmet use increased with age (P=.01). Days in the intensive care unit were proportional to both GCS score (r_s=-0.47; P=.002) and ISS (r_s=0.6; P≤.001). Length of hospitalization also correlated with both GCS score (r_s=-0.03; P=.008) and ISS (r _s=0.54; P=.02). CONCLUSION: Snowmobiles are a significant source of multi-trauma for children. Orthopedic injuries predominate, especially in older children, and can lead to long-term disabilities. Helmet use significantly reduces injuries; however, vulnerable younger patients do not frequently wear helmets.