All-terrain vehicles are a popular way to explore the trails and rural terrain across South Carolina and North Carolina, but they carry far more risk than most riders appreciate before getting on one. The open design, high center of gravity, and off-road conditions create an environment where a single mistake or someone else’s negligence can result in a life-altering injury in seconds.
If you or someone you love has been hurt in an ATV accident, understanding the types of injuries involved and your legal options is the first step toward getting the help you need.
Why ATV Accidents Are So Dangerous
ATVs are heavy, fast-moving vehicles with a high center of gravity and no protective enclosure around the rider. Unlike a car, there are no airbags, no seatbelts, and no crumple zones standing between the rider and the ground, or a tree, a ditch, or another vehicle. According to the U.S. Consumer Product Safety Commission’s 2024 OHV Annual Report, there were an estimated 99,800 emergency department-treated injuries involving ATVs, ROVs, and UTVs in 2023 alone, roughly 100,000 injuries in a single year. Over the five-year period from 2019 to 2023, that figure totals an estimated 509,900 emergency department visits.
Rollovers are among the leading mechanisms of injury. CPSC data shows that ATVs overturned in at least 65 percent of fatal incidents, and because riders are not restrained, ejection is the near-universal result. The terrain of the Carolinas, uneven, often wooded, and seasonally wet, only amplifies those risks.
Traumatic Brain Injuries
Traumatic brain injuries, or TBIs, are among the most devastating outcomes of ATV crashes. When a rider is thrown from the vehicle and lands headfirst, or when the ATV rolls and the rider is pinned beneath it, the force delivered to the skull can cause anything from a concussion to severe, irreversible brain damage.
Helmet use significantly reduces this risk, yet many riders, particularly those operating on private land, choose to ride without one. North Carolina law requires all ATV operators and passengers under the age of 18 to wear a helmet; South Carolina’s Chandler’s Law similarly restricts how young children may operate ATVs. Even so, enforcement is limited once riders leave public land.
TBIs often cause lifelong consequences like memory loss, personality changes, speech and motor difficulties, chronic headaches, or, in severe cases, permanent incapacitation or death. Medical costs can reach hundreds of thousands of dollars, not including lost income or continuous care.
Spinal Cord and Back Injuries
The spine is particularly vulnerable in ATV accidents. High-impact landings, being crushed under a rolled vehicle, or colliding with a fixed object can fracture vertebrae, herniate discs, or sever or compress the spinal cord entirely. Research published in the National Institutes of Health’s National Library of Medicine (PMC) found that ATV-related spinal injuries disproportionately affect younger riders, with a mean age at injury of approximately 26 to 29 years.
Spinal cord injuries at or above certain vertebral levels can result in partial or complete paralysis, paraplegia, or quadriplegia. Even injuries that fall short of full paralysis can cause chronic pain, numbness, weakness, and reduced mobility that fundamentally alter a person’s ability to work and live independently. According to the National Spinal Cord Injury Statistical Center’s 2024 report, there are approximately 18,000 new traumatic spinal cord injuries in the United States each year, with vehicle-related incidents, including ATV crashes, consistently among the leading causes.
Fractures and Orthopedic Injuries
Broken bones are among the most common physical injuries in ATV crashes. When a rider is ejected and lands on their outstretched arms, wrist and forearm fractures are typical. Leg fractures frequently occur when a rider is pinned under a rolled ATV. Rib fractures are common in side-impact collisions or when riders strike the handlebars. Shoulder and clavicle fractures happen when riders are thrown sideways.
Some fractures heal fully with casting and rest. Others, particularly compound fractures, fractures involving joint surfaces, or fractures requiring surgical repair with rods, screws, or plates, involve lengthy recovery periods, physical therapy, and the possibility of long-term complications such as arthritis, reduced range of motion, or hardware failure.
Internal Organ Injuries
Blunt-force trauma to the abdomen is a serious and sometimes underappreciated consequence of ATV accidents. Handlebar impacts, where the rider is thrown forward, and the handlebars drive into the midsection, are a well-documented cause of internal injuries, particularly to the liver, spleen, and kidneys. Crush injuries, where the vehicle lands on the rider, can rupture internal organs and cause dangerous internal bleeding.
Internal injuries are often not immediately obvious. A rider may walk away from a crash appearing uninjured, only to develop worsening abdominal pain, dizziness, and signs of internal bleeding in the hours that follow. Any ATV accident involving significant abdominal impact or blunt trauma warrants prompt emergency evaluation, even if the person feels relatively well immediately after the crash.
Soft Tissue, Lacerations, and Road Rash
Not every ATV injury is catastrophic, but even “minor” injuries can carry significant consequences. Deep lacerations from contact with the vehicle, rocks, or tree branches can sever nerves or tendons, cause significant blood loss, or become infected if not properly treated. Road rash, abrasion injuries caused by sliding across ground or gravel, can strip away layers of skin and tissue and require wound care over an extended period.
Soft tissue injuries, including sprains, torn ligaments, and muscle tears, frequently affect the knees, shoulders, and ankles in ATV crashes. These injuries may not appear serious on initial imaging but can cause lasting instability, chronic pain, and functional limitations that affect a person’s ability to work physical jobs common throughout North Carolina and South Carolina.
Children Face Disproportionate Risk
ATV accidents are not just an adult concern. Children are involved in a troubling proportion of serious ATV injuries and fatalities. According to CPSC data, children under 16 account for approximately 27 percent of all OHV-related injuries treated in U.S. emergency departments. In North Carolina specifically, historical NCDPH data show that head injuries accounted for the majority of ATV-related child fatalities, and that only a small fraction of children killed were wearing helmets at the time.
Both North Carolina and South Carolina have enacted age-based restrictions on ATV use by minors, but those laws do not eliminate the risk; they set a floor. Parents and property owners who allow children to ride ATVs without proper protective equipment, supervision, or age-appropriate vehicles may bear legal responsibility when a child is seriously hurt.
Protecting Your Legal Rights After an ATV Accident
ATV accidents can result in devastating, permanent injuries that affect every aspect of a victim’s life. At Stewart Law Offices, our ATV accident attorneys have more than 30 years of experience helping injured victims in North Carolina and South Carolina pursue the compensation they deserve, including coverage for medical expenses, lost wages, rehabilitation costs, and pain and suffering.
Whether your accident occurred on a private trail in the Upstate, a rural property in the Piedmont, or anywhere else in the Carolinas, we are ready to fight for you. Contact our South Carolina motorcycle accident lawyers or North Carolina motorcycle accident lawyers at Stewart Law Offices today for a free consultation.