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Orthopaedic injuries, including broken arms and legs, dislocated hips, and foot amputations, are common after ATV accidents. Head injuries are also common and are the leading cause of death.

Many injuries occur when an ATV rolls over, landing on the operator or passenger. Other injuries result when an operator loses control of an ATV, is thrown or falls from an ATV, or collides with another vehicle or a fixed object, such as a tree. Driver inexperience, excessive speed, lack of helmet use, and intoxication are all risk factors for injury.

Because of their inherent danger, the American Academy of Orthopaedic Surgeons (AAOS) considers ATVs to be a significant public health risk.

To help reduce the numbers of injuries and deaths, particularly among young people, the AAOS—along with the Orthopaedic Trauma Association and the Pediatric Orthopaedic Society of North America—recommends that:

• All ATV operators should be licensed and undergo a hands-on training course. Both children and adults should be able to demonstrate competence in handling the vehicle and knowledge of the potential safety hazards.
• ATVs should never be driven by a child younger than the age of 12. Younger children do not have adequate physical size and strength to control these vehicles. Nor do they have the motor skills, coordination, and judgment needed to operate a vehicle safely.
• Children between the ages of 12 and 16 should have limitations on their use of ATVs. They should be supervised by a responsible adult. Children under 16 years of age should only operate age-appropriate models that have an engine size of 90 cc or less.
• Operators should always wear protective gear. Helmets are especially important in reducing the risk of head injury. Wearing protective gloves, goggles, heavy boots, and long pants can also help reduce injuries.
• ATVs should only be used during daylight hours. In the varied terrain in which ATVs are most commonly used, good visibility is required. Riding after dark is especially dangerous. The lights attached to an ATV cannot provide enough properly directed illumination when the vehicle is bouncing or turning.
• Only one person should ride a vehicle intended for single person use. Adding a passenger increases the likelihood that the ATV will tip or turn over.
• Do not operate an ATV if you have taken drugs or alcohol. A large number of ATV-related fatalities involve alcohol use.

Here are some additional safety tips for ATV use. Following these guidelines could help reduce your risk of injury.

• Read all instruction manuals and follow the manufacturers' recommendations for use, maintenance, and pre-use checks.
• Do not operate an ATV at excessive speeds. With their narrow wheel base and high center of gravity, ATVs are unstable and can easily flip when traveling at a high rate of speed on uneven ground. Except under very specific circumstances, in most areas it is illegal to operate off-road vehicles on public roads and highways. Check your local laws to determine whether you are able to operate your ATV on public roads and, if so, always obey the rules of the road.