Return to car driving is safe 6 weeks after operative treatment of right ankle fractures

Ho, Sean Wei Loong; Yam, Michael; Chan, Mei Leng; Kwek, Ernest Beng Kee

doi:10.1007/s00402-018-3037-3

Cited by 13 publications

(20 citation statements)

References 13 publications

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“…Furthermore, the importance of returning to driving is key for some patients and there is often a lack of definitive guidance given to patients regarding this. 19 This study compares to another qualitative study completed with those with ankle fracture 10 who also demonstrated wideranging effects on individuals with ankle fracture, including social and psychological impacts as well as activities of daily living. There were some differences of this study, in that here we focused only on patients with an ankle fracture, whereas the previous research also interviewed clinicians.…”

Section: Discussionmentioning

confidence: 88%

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Patient experiences of an ankle fracture and the most important factors in their recovery: a qualitative interview study

et al. 2020

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ObjectiveThe objective of this qualitative research study is to explore patient experiences of ankle fracture and the factors most important to them in recovery.DesignSemistructured interviews exploring patient experiences of ankle fracture recovery at 16–23 weeks following injury. Interviews followed a topic guide and were recorded with an encrypted audio recorder and then transcribed verbatim. Thematic content analysis was used to identify themes in the data.SettingIndividuals were recruited from a sample of participants of a UK-based clinical trial of immobilisation methods for ankle fracture (ISRCTN15537280 at the pre-results stage at time of writing). Interviews were conducted at the participants’ own homes or on a university campus setting.ParticipantsA purposive sample was used to account for key variables of age, gender and fracture management. Participants recruited from the clinical trial sample were adults aged 18 years or over with a closed ankle fracture.ResultsTen participants were interviewed, five of whom were female and six of whom needed an operation to fix their ankle fracture. The age range of participants was 21–75 years with a mean of 51.6 years. Eight themes emerged from the data during analysis; mobility, loss of independence, healthcare, psychological effects, social and family life, ankle symptoms, sleep disturbance and fatigue, and activities of daily living. Factors of importance to participants included regaining their independence, sleep quality and quantity, ability to drive, ability to walk without walking aids or weight-bearing restrictions, and radiological union.ConclusionsThe results of this research demonstrates the extensive impact of ankle fracture on individuals’ lives, including social and family life, sleep, their sense of independence and psychological well-being. The results of this study will enable an increased understanding of the factors of relevance to individuals with ankle fracture, allowing collection of appropriate outcomes in clinical studies for this condition. Ultimately these results will help formulate appropriate patient-centred rehabilitation plans for these patients.Trial registration numberISRCTN15537280; Pre-results

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Section: Discussionmentioning

confidence: 88%

“…The prevalence of psychological effects such as anxiety and depression reported in this study indicates that a more holistic approach to intervention is required following trauma. Furthermore, the importance of returning to driving is key for some patients and there is often a lack of definitive guidance given to patients regarding this 19…”

Section: Discussionmentioning

confidence: 99%

Patient experiences of an ankle fracture and the most important factors in their recovery: a qualitative interview study

et al. 2020

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“…First, it has inherently limited real-world application. There are some considerations on how to change this, as one study that looked at return to driving after right ankle open reduction and internal fixation had patients go through an on-road exercise in the style of the national driver's license examination as the final test to determine if the patient would be able to safely return to driving post-operatively [16]. While this method would be more time consuming and less cost-effective, it would reduce the limitations of a driving simulator.…”

Section: Discussionmentioning

confidence: 99%

Return to Driving after Elective Foot and Ankle Surgery: A Systematic Review

et al. 2022

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(1) Background: This systematic review summarizes the available studies investigating when it is safe for most patients to return to driving and when to modify for individual patients following elective foot and ankle procedures. (2) Methods: A systematic review of the literature was performed using three different electronic databases to identify English-language studies from 1999 to present that investigate the return to driving after right-sided elective foot and ankle procedures. (3) Results: A total of eight studies met inclusion criteria. All the studies investigated brake reaction time (BRT) as measured by a driving simulator as their primary outcome. Patients undergoing right ankle or subtalar arthroscopy should wait 2 weeks to drive, after total ankle arthroplasty or corrective hallux valgus surgery patients should wait 6 weeks, and the appropriate time to return to driving after ankle arthrodesis is still uncertain. Additionally, various clinical factors can be used to predict who may still be unfit to drive past the usual length of time. (4) Conclusions: The recommendations from these reviewed studies can guide physicians when counseling their patients on when they can expect to safely return to driving after a specific elective foot and ankle procedure. However, these recommendations should be tailored to the patient specifically based upon how they are doing clinically.

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“…[7][8][19][20][21] A 2018 prospective clinical study investigating return to car driving after operative treatment of right ankle fractures, used a stationary reaction timer consisting of a computer screen and an external driving simulator to measure break reaction time at three postoperative time points. [1] However, brake response time might not be the best estimator of driving ability considering the numerous effects that orthopaedic injuries and operations can have on a patient's return to driving. Pain and range of motion have been shown to significantly affect driving ability and safety.…”

Section: Discussionmentioning

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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Return to car driving is safe 6 weeks after operative treatment of right ankle fractures

Abstract: II.

Cited by 13 publications

References 13 publications

Patient experiences of an ankle fracture and the most important factors in their recovery: a qualitative interview study

Patient experiences of an ankle fracture and the most important factors in their recovery: a qualitative interview study

Return to Driving after Elective Foot and Ankle Surgery: A Systematic Review

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

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