Snowmobile injuries in children and adolescents.

OBJECTIVE: To characterize 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 hospitalization 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 multitrauma 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.