Driving after Distal Radius Fractures

Distal radius fractures (DRF) are a common orthopaedic injury, affecting over 640,000 people per year in the United States, and may account for 2.5% of emergency department visits. The treatment for DRF may be operative or non-operative, but both treatment options require a period of immobilization to allow healing. Pain, stiffness, and weakness are invariably present after this fracture and typically improve gradually over time. One of the most common questions orthopedic surgeons are asked following a DRF is, “When can I drive?” Survey studies of physicians across multiple countries show a lack of standardization regarding recommendations, with little agreement regarding either criteria or timeframe for return to driving. The pilot study aimed to evaluate the effect of DRF on safety of roadway users, particularly drivers in passenger vehicles, and provide valuable information to physicians in counseling their patients on return to safe driving. Subjects were evaluated at 2, 6, and 12 weeks post operatively. At post-op visits clinical data were obtained. These data included demographics (sex, age, hand dominance, laterality of DRF), splint usage, narcotic usage, and range of motion. The driving simulation portion of the study occurred within 1 week of the post-operative clinic visits. The driving simulation used the miniSim research driving simulator. Each testing visit consisted of two separate driving scenarios preceded by a 5-minute practice drive. The first driving scenario included urban and rural driving environments that include curves and 90-degree turns. Some oncoming traffic was present, however, no traffic or pedestrian required the patient to change position or speed to avoid a crash. The second experimental drive involved a crash-imminent situation in which the driver had to rapidly change direction of travel to effectively respond to the event and avoid a crash. Preliminary data from the first 4 fracture subjects and a control dataset were analyzed. No differences in standard deviation of lane position were observed under any normal driving conditions. Average speed with respect to the speed limit in fractures compared with controls was significantly slower. However, fractures differed from controls in terms of the frequency and speed of steering inputs. Two weeks post-surgery, 3 out of 4 subjects failed to avoid the crash, with one not initiating a steering response and two not providing enough steering input to avoid the crash. Preliminary results suggest patients 2 weeks after DRF volar plating are able to maintain lane position but with overall lower speed and fewer steering inputs, and with 75% (3 of 4) failing to avoid collision on a crash-avoidance task. With continued enrollment, a larger sample size will provide further insight into when DRF patients may safely return to driving.

• Record URL:
  http://safersim.nads-sc.uiowa.edu/final_reports/UI-3-Y3_ReportFinal.pdf
• 
• Supplemental Notes:
  • This document was sponsored by the U.S. Department of Transportation, University Transportation Centers Program.
• Corporate Authors:

  University of Iowa, Iowa City

  Department of Orthopaedics
  Iowa City, IA  United States 

  University of Iowa, Iowa City

  National Advanced Driving Simulator, 2401 Oakdale Blvd
  Iowa City, IA  United States  52242-5003

  Safety Research Using Simulation University Transportation Center (SaferSim)

  University of Iowa
  Iowa City, IA  United States  52242

  Office of the Assistant Secretary for Research and Technology

  University Transportation Centers Program
  Department of Transportation
  Washington, DC  United States  20590
• Authors:
  • Caldwell, Lindsey
  • Brown, Timothy
  • Glass, Natalie
  • Schmitt, Rose
  • 0000-0002-8712-975X
  • McGill, Patrick
• Publication Date: 2017-6

Language

• English

Media Info

• Media Type: Digital/other
• Features: Figures; Photos; References; Tables;
• Pagination: 20p

Subject/Index Terms

• TRT Terms: Arm; Driving; Driving simulators; Fractures (Anatomy); Highway safety; Passenger vehicles; Pilot studies
• Subject Areas: Highways; Safety and Human Factors;

Filing Info

• Accession Number: 01642604
• Record Type: Publication
• Files: UTC, NTL, TRIS, ATRI, USDOT
• Created Date: Jul 28 2017 5:13PM