Background The use of powered off road vehicles including motorcycles, quad-bikes and off-road vehicles, is a leading cause of injury and death in children. To inform injury prevention measures, there is a need to identify risk factors injury related to the vehicle, rider, the riding environment and type of riding being undertaken.

Methods Our aims are to investigate the factors that increase the risk of crashing among children using powered off road vehicles. We are conducting a prospective in-depth case-control study. Cases are children <16 years who attend any paediatric trauma hospital in the state of New South Wales, Australia. Controls are age and gender matched children who have ridden off-road vehicles in the last year, recruited through social media and advertising through riding and training organisations. Case numbers will be limited by the number of children presenting to hospital, we expect a final sample of 50–70 children. Our aim is to collect 2–3 controls per case, so the estimated control sample size is 210. For cases, data collection involved in-depth interviews, inspection of the crash site, vehicle and protective equipment. For controls, data collection is via an online survey. Information on riding history, training, behaviours, locations and purpose, as well as rider anthropometry, vehicle type and protective equipment will be collected from both samples. Conditional logistic regression modelling will be used to conduct the case-control analysis.

Results To date, 20 cases have been recruited and 40 control riders. Of the first 12 cases with complete data, all have been males aged between 4 and 15 years. Almost all (11/12) wore helmets and full protective gear at the time of the crash. Injury severity ranged from AIS1-5. Most crashes involved a loss of control or impacting fences.

Conclusions This study will provide an in-depth analysis of risk factors related to children riding powered off road vehicles. It could inform the development of injury preventative strategies in terms of regulation, training, legislation, licensing, vehicle and equipment design and manufacture.