Put On The Brakes After Foot Or Ankle Surgery

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Put On The Brakes After Foot Or Ankle Surgery

http://www.medicalnewstoday.com/articles/211674.php

Patients recovering from a right foot injury or surgery should think twice about

how soon they want to begin driving again. According to a new study from the

Journal of Bone and Joint Surgery (JBJS), it takes much longer to brake when the

driver is wearing an immobilization device like a splint or brace, than it does

when wearing normal footwear.

Driving is important to many people's social and professional lives, so when a

person's right ankle or foot must be immobilized after an injury or surgery, one

of the first questions an orthopaedic surgeon hears is, " When can I start

driving again? "

To answer this question, researchers measured emergency braking time in people

using a brake adapted for use by the left foot, or wearing a short leg cast, a

controlled ankle-motion boot, or normal footwear. The results showed that all of

the devices, except for normal footwear, impaired the drivers' ability to brake

quickly.

" We did not find a device that was as safe as normal footwear, " says CPT

Dowd, MD, an orthopaedic surgeon in the Department of Orthopedics and

Rehabilitation at Army Medical Center in Fort Sam Houston, Texas. " We

only tested emergency braking situations, but it's reasonable to assume that if

a person cannot stop quickly in an emergency, it may not be safe for that person

to be driving. "

Study details and findings:

-- Compared with an individual wearing normal footwear, an individual traveling

at a highway speed of 60 miles per hour (mph) (96.6 km/hr) would travel an

additional 9.2 feet (2.8 m) during emergency braking when wearing a right

lower-extremity controlled-ankle-motion boot.

-- A driver wearing a right lower-extremity short leg cast would travel an

additional 6.1 feet (1.9 m) before coming to an emergency stop.

-- A driver using a left-foot braking adapter would travel an additional 6.0

feet (1.8 m).

-- At a community-driving speed of 35 mph (56.3 km/hr), these same individuals

would travel an additional 5.4 feet (1.6 m), 3.6 ft (1.1 m), and 3.5 feet (1.1

m), respectively. These changes in distance traveled might represent the

difference between being involved in or avoiding a collision in an emergency

setting.

-- The effect of immobilization devices on fine braking scenarios such as

navigating a curve or driving in stop-and-go traffic is unknown, but according

to study authors, it is likely to be greater.

-- The test subjects were healthy adults who had not recently undergone surgery

or sustained an injury, so their braking response times are likely to be

somewhat better than individuals having discomfort or other symptoms due to

their medical condition.

" Based on our findings, " Dr. Dowd said, " we cannot recommend that any patient

return to driving using a brake adapter or wearing an immobilization device on

the right foot. Orthopaedic surgeons need to educate their patients about these

safety concerns when discussing the best time to begin driving again. "

Other relevant facts and statistics noted in the study:

-- The ability to perform an emergency stop is essential for safe driving and

can be represented by total brake-response time, reaction time, and braking

time.

-- Survey studies indicated that more than 90 percent of orthopaedic surgeons

would generally not recommend that a patient drive while immobilized in a right

lower-extremity short leg cast.

-- Under the terms of most insurance policies, the insurer is not obligated to

cover accidents in which the driver was still recovering from an earlier injury

or operation.

Source: American Academy of Orthopaedic Surgeons