“Doctor, can I drive?”: The need for a rational approach to return to driving after musculoskeletal injury

Roberts, Craig S.; Protzer, Lauren

doi:10.1016/j.injury.2016.02.010

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…Most interviewees recalled following the advice provided by their surgeon with respect to driving. The importance of appropriate guidance about driving after injury or surgery has been highlighted for other musculoskeletal injuries and conditions 8 ; however there are currently no clear recommendations for return to driving after CTR. Interestingly, interviewees were reluctant to return to work before the period stated on any sickness certification, as this was viewed as acting against medical advice.…”

Section: Introductionmentioning

confidence: 99%

Driving, work, wound care and rehabilitation after carpal tunnel release: Consensus recommendations from a UK Delphi study

2022

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Introduction There is variability in the information available for patients after carpal tunnel release (CTR). We aimed to establish (i) what advice should be provided regarding return to driving after CTR; (ii) how work activities should be categorised and defined in relation to CTR, and when patients should be recommended to return to these activities; (iii) what wound care and rehabilitation advice should be provided after CTR. Methods We developed consensus recommendations from an expert panel of hand surgeons, primary care surgeons and hand therapists using an electronic Delphi process. Participants were recruited from clinical organisations using pre-defined criteria. Delphi questionnaires included open text and tick-box responses. Consensus was defined as ≥75% agreement and summary feedback was provided after each round. Results There were 33 panellists (21 surgeons and 12 hand therapists), of which 27 (82%) completed all rounds. Expected return to driving was agreed as 5–14 days. Expected timescales were also agreed for return to seven selected occupational activities. Post-operative advice focused on using and moving the hand, rather than specific rehabilitation. While consensus was reached for most items, there were important areas of disagreement, including divergent views on driving with sutures in situ and the need to inform car insurers. Conclusion Recommendations from this study expand on existing advice by including functional descriptors for occupational activities and guidance timescales generated through a formal consensus process. Areas where consensus was not reached warrant further exploration to assess whether different practices impact clinical and functional outcomes for patients.

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Section: Introductionmentioning

confidence: 99%

Driving, work, wound care and rehabilitation after carpal tunnel release: Consensus recommendations from a UK Delphi study

2022

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“…While broadly accepted return to driving guidelines for lower extremity fracture patients are lacking; simulation studies, meta-analyses, and editorials summarizing the evidence are available. [1][2][3][4][5] Several studies have been conducted to explore patients' driving performance after orthopaedic procedures of lower extremity injuries, focusing on the patient's brake reaction time (BRT) returning to normal. [3,[6][7] Although BRT is an important measure N. N. O'Hara reported receiving stock or stock options from Arbutus Medical, Inc. unrelated to this research.…”

Section: Introductionmentioning

confidence: 99%

“…Patients commonly ask their physician when they can return to driving after management of a lower extremity fracture. While broadly accepted return to driving guidelines for lower extremity fracture patients are lacking; simulation studies, meta-analyses, and editorials summarizing the evidence are available [1–5] . Several studies have been conducted to explore patients’ driving performance after orthopaedic procedures of lower extremity injuries, focusing on the patient's brake reaction time (BRT) returning to normal [3,6–7] .…”

Section: Introductionmentioning

confidence: 99%

Patients value their own pain over braking safety when deciding when to return to driving: a discrete choice experiment on lower extremity injuries

DeLeon

Rolle

Burke

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objective:To quantify patient preferences towards time to return to driving relative to compromised reaction time and potential complication risks.Design:Cross-sectional discrete choice experiment.Setting:Academic trauma center.Patients:Ninety-six adult patients with an operative lower extremity fracture from December 2019 through December 2020.Intervention:None.Main Outcome Measurement:Patient completed a discrete choice experiment survey consisting of 12 hypothetical return to driving scenarios with varied attributes: time to return to driving (range: 1 to 6 months), risk of implant failure (range: 1% to 12%), pain upon driving return (range: none to severe), and driving safety measured by braking distance (range: 0 to 40 feet at 60 mph). The relative importance of each attribute is reported on a scale of 0% to 100%.Results:Patients most valued a reduced pain level when resuming driving (62%), followed by the risk of implant failure (17%), time to return to driving (13%), and braking safety (8%). Patients were indifferent to returning to driving at 1 month (median utility: 28, interquartile range [IQR] −31 to 80) or 2 months (median utility: 59, IQR: 41 to 91) postinjury.Conclusion:Patients with lower extremity injuries demonstrated a willingness to forego earlier return to driving if it might mean a decrease in their pain level. Patients are least concerned about their driving safety, instead placing higher value on their own pain level and chance of implant failure. The findings of this study are the first to rigorously quantify patient preferences toward a return to driving and heterogeneity in patient preferences.Level of Evidence:V

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Empfehlungen zur Fahrtauglichkeit bei Erkrankungen des Bewegungs- und Stützapparates

Latz¹,

Schiffner

Schneppendahl³

et al. 2018

Unfallchirurg

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“Doctor, can I drive?”: The need for a rational approach to return to driving after musculoskeletal injury

Cited by 8 publications

References 22 publications

Driving, work, wound care and rehabilitation after carpal tunnel release: Consensus recommendations from a UK Delphi study

Driving, work, wound care and rehabilitation after carpal tunnel release: Consensus recommendations from a UK Delphi study

Patients value their own pain over braking safety when deciding when to return to driving: a discrete choice experiment on lower extremity injuries

Empfehlungen zur Fahrtauglichkeit bei Erkrankungen des Bewegungs- und Stützapparates

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