PURPOSE:
Severe crush injuries to the hand are infrequently reported in the literature. However, our level I trauma center has experienced a recent increase in such injuries previously described as the “roll-bar hand.” We report a case series associated with the introduction of a new type of all-terrain vehicle known as the Yamaha Rhino.
METHODS:
All adult and pediatric patients treated by the Department of Plastic Surgery at Loma Linda University for hand injuries incurred during use of the Rhino all-terrain vehicle were reviewed . We also report the prevalence associated injuries and injury severity score.
RESULTS:
We have found a similar pattern of injury as described in the 1978 article by Charters and Davis regarding the use of dune buggies. Roll-bar hand includes severe bony and soft tissue injuries of the ulnar three to four digits with relative sparing of the thumb. All patients demonstrated open comminuted fractures with crush-avulsion soft tissue injury. The majority required some degree of amputation revision. Most of the patients injuries were isolated to the hand.
CONCLUSION:
Rhino roll-bar injuries are severe, disabling, and have a poor prognosis. Improvements in operator education, age limitations on usage, and industry design may reduce the incidence and severity of these injuries.