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

Archives of Orthopaedic and Trauma Surgery volume 138, pages 1691–1697 (2018)Cite this article

Abstract

Background

There is no clear consensus on when patients with surgically treated right ankle fractures can return to car driving, or how best to assess their fitness to drive. Through a rigorous driving assessment program consisting of both off-road and on-road tests, we aim to determine if these patients are able to pass a standard driving test, even before weight bearing has been initiated.

Methods

A prospective grant-funded (Supported by AOTrauma Asia Pacific Ref: AOTAP12-17) clinical study was conducted. Patients aged 25–65 years who underwent surgery for right ankle fractures and held a valid motorcar driving license were recruited in a single institution from 2013 to 2015. The surgeon and a specialist occupational therapist assessed the patients at 2, 6 and 12 weeks post-surgery. A Short Musculoskeletal Functional Assessment (SMFA) Questionnaire was administered and the brake reaction time was measured using a driving simulator. Patients who met the minimal criteria were then subjected to a full on-road driving test in a real-world environment with a driving instructor. A follow-up telephone questionnaire was administered at least 6 months after return to driving to determine if patients had returned to driving safely.

Results

A total of 23 patients (8 females, 15 males) were recruited. The mean age was 42.8 (± 12.9) years. There was a significant improvement in the SMFA (p < 0.05) and braking time (p < 0.05) at 6 and 12 weeks post-surgery. Nearly all (91%) patients passed the on-road driving test at 6 weeks, before their fractures had healed or weight bearing was initiated. The questionnaire administered at least 6 months after return to driving revealed that all patients had returned to regular driving safely.

Conclusion

We conclude that patients with isolated, surgically treated right ankle fractures can successfully pass a standard driving test at 6 weeks post-surgery, even before weight bearing has been initiated. We also showed that the ability to drive correlates with improvements in the SMFA scores and braking times.

Level of evidence

II.

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Acknowledgements

We would like to acknowledge the statistical support from Ms Sun Bing from TTSH CRIO.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore

    Sean W. L. Ho, Michael Yam & Ernest B. K. Kwek

  2. Department of Occupational Therapy, Tan Tock Seng Hospital, Singapore, Singapore

    M. L. Chan

Authors
  1. Sean W. L. Ho
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  2. Michael Yam
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  3. M. L. Chan
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  4. Ernest B. K. Kwek
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Corresponding author

Correspondence to Sean W. L. Ho.

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The author(s) declare(s) that there is no conflict of interest.

Ethical approval

This study was approved by our institutional review and ethics board.

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Ho, S.W.L., Yam, M., Chan, M.L. et al. Return to car driving is safe 6 weeks after operative treatment of right ankle fractures. Arch Orthop Trauma Surg 138, 1691–1697 (2018). https://doi.org/10.1007/s00402-018-3037-3

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  • DOI: https://doi.org/10.1007/s00402-018-3037-3

Keywords

  • Car driving
  • Ankle fractures
  • SMFA Score
  • Braking reaction time