Fitness to drive in a below knee plaster? An evidence based response

Nunn, Tom; Baird, C.; Robertson, Daniel W.; Gray, I.; Gregori, A.

doi:10.1016/j.injury.2007.04.015

Cited by 9 publications

(8 citation statements)

References 2 publications

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“…With no strict guidance for temporary disabilities physicians again face a dilemma. A study by Nunn et al 17 21 In the United States Chen et al 22 proposed a return-to-driving-policy at one trauma centre. The policy states that clinicians no longer 'clear' patients for driving but only advise them when they might be ready for assessment with the Department of Motor Vehicles.…”

Section: Discussionmentioning

confidence: 99%

“…Table I lists the literature survey. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Most clinical studies used the BRT and total braking time as the outcome measures, but a few measured the BPF. The BRT varied between 0.5 to 1.5 seconds with varying recovery periods proposed based on the type and severity of injury or surgery, as well as the BRTs of the controls.…”

Section: Methodsmentioning

confidence: 99%

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“When can I return to driving?”

Macleod

Lingham

Chatha

et al. 2013

The Bone & Joint Journal

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Clinicians are often asked by patients, "When can I drive again?" after lower limb injury or surgery. This question is difficult to answer in the absence of any guidelines. This review aims to collate the currently available evidence and discuss the factors that influence the decision to allow a patient to return to driving. Medline, Web of Science, Scopus, and EMBASE were searched using the following terms: 'brake reaction time', 'brake response time', 'braking force', 'brake pedal force', 'resume driving', 'rate of application of force', 'driving after injury', 'joint replacement and driving', and 'fracture and driving'. Of the relevant literature identified, most studies used the brake reaction time and total brake time as the outcome measures. Varying recovery periods were proposed based on the type and severity of injury or surgery. Surveys of the Driver and Vehicle Licensing Agency, the Police, insurance companies in the United Kingdom and Orthopaedic Surgeons offered a variety of opinions. There is currently insufficient evidence for any authoritative body to determine fitness to drive. The lack of guidance could result in patients being withheld from driving for longer than is necessary, or returning to driving while still unsafe.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“When can I return to driving?”

Macleod

Lingham

Chatha

et al. 2013

The Bone & Joint Journal

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“…In total, 68 studies were identified meeting our study aims and inclusion criteria for both upper and lower extremity procedures ( Fig. 1 , Table 1 , Supplementary Tables 1 and 2) ( 1 , 14 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ). There was a wide variation in procedures performed and sample size, the study methodology, and measurements obtained.…”

Section: Resultsmentioning

confidence: 99%

“…There were 36 lower extremity studies included in the review ( 4 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ) A total of 1021 patients were assessed, with 1006 having right-sided procedures and 15 left-sided procedures. The summary of these data is presented in Supplementary Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Return to driving post upper or lower extremity orthopaedic surgical procedures: a scoping review of current published literature

Khaliq,

Giannoudis,

Palan

et al. 2023

EFORT Open Reviews

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Patients undergoing planned or unplanned orthopaedic procedures involving their upper or lower extremity can prevent them from safe and timely return to driving, where they commonly ask, ‘Doctor, when can I drive?’ Driving recommendations after such procedures are varied. The current evidence available is based on a heterogenous data set with varying degrees of sample size and markedly differing study designs. This instructional review article provides a scoping overview of studies looking at return to driving after upper or lower extremity surgery in both trauma and elective settings and, where possible, to provide clinical recommendations for return to driving. Medline, EMBASE, SCOPUS, and Web of Science databases were searched according to a defined search protocol to elicit eligible studies. Articles were included if they reviewed adult drivers who underwent upper or lower extremity orthopaedic procedures, were written in English, and offered recommendations about driving. A total of 68 articles were included in the analysis, with 36 assessing the lower extremity and 37 reviewing the upper extremity. The evidence available from the studies reviewed was of poor methodological quality. There was a lack of adequately powered, high quality, randomised controlled trials (RCTs) with large sample sizes to assess safe return to driving for differing subset of injuries. Many articles provide generic guidelines on return to driving when patients feel safe to perform an emergency stop procedure with adequate steering wheel control. In future, RCTs should be performed to develop definitive return to driving protocols in patients undergoing upper and lower extremity procedures.

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

Roberts

Protzer

2016

Injury

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Fitness to drive in a below knee plaster? An evidence based response

Cited by 9 publications

References 2 publications

“When can I return to driving?”

“When can I return to driving?”

Return to driving post upper or lower extremity orthopaedic surgical procedures: a scoping review of current published literature

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

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