Surgeons Seeing More ‘Mutilating’ Hand Injuries With New Utility Terrain Vehicles

A popular type of off-road vehicle known as a “side-by-side” has been linked to high rates of severe hand injuries, according to a new study.

Side-by-sides are utility terrain vehicles (UTVs) designed to carry more than one passenger and heavy loads. All-terrain vehicles (ATVs) are usually made for one driver going off-road.

“Our study finds much higher rates of mutilating hand injuries and amputations associated with side-by-side UTVs, compared to ATVs,” said lead author Dr. Shaun Mendenhall, of the University of Pennsylvania Perelman School of Medicine, in Philadelphia.

Mendenhall worked on the study with colleagues at his former school, the University of Utah. The report was published in the October issue of the journal Plastic and Reconstructive Surgery.

“We believe hand surgeons can play a key role in increasing awareness and prevention of ATV-related hand injuries,” Mendenhall said in a journal news release.

Utility terrain vehicles have side-by-side passenger seating, safety belts and a rollover protection system, but the American Society of Plastic Surgeons suggests this may create a false illusion that UTVs are safer than ATVs. ATVs have straddle seating, no safety belt and no rollover protection.

The study developed after University of Utah hand surgeons began seeing more hand, arm and shoulder injuries in UTV riders. Between 2010 and 2021, they treated 87 patients who were injured in ATV accidents and 67 who were injured in UTV accidents.

Although rates of upper extremity injuries were similar, UTV riders had significantly higher rates of mutilating injuries. The researchers defined mutilating injuries as ones resulting in irreparable damage to the appearance and function of the hand.

UTV riders had triple the number of these injuries compared to ATV riders (64% compared to 22%), and nearly 10 times the number of amputations (30% versus 3%), according to the report.

UTV patients had twice as many surgeries and were hospitalized for about five days, compared to 2.5 for ATV riders.

Injuries occurred in UTV drivers, as well as passengers, of all ages. Seatbelt use was unrelated to the risk of injury or amputations. Data on the use of other protective equipment, such as mesh windows or doors and wrist straps, was inconclusive.

The authors said UTVs may be “a new source of mutilating hand injuries.”

The researchers said injury patterns were consistent with those previously described in riders who extend their hands outside the vehicle during a rollover accident, with “a high likelihood of having their hand crushed between the ROPS [rollover protection system] and the ground.”

Hand surgeons and vehicle manufacturers should work together to promote safe riding habits and safe products, the study authors advised.

More information

The U.S. Consumer Product Safety Commission has more on safety and off-road vehicles.

SOURCE: Plastic and Reconstructive Surgery, news release, Sept. 28, 2023