Driving plastered: who does it, is it safe and what to tell patients

The number and safety of patients who drive in an upper limb fracture cast has been largely untested. This study investigates the proportion of persons who drive in their casts and the capability of a casted persons driving is also assessed. The stance of government and insurance bodies is reviewed. The aim is to provide a guide for when a doctor should advise a patient not to drive while wearing an upper limb fracture cast.

Patients attending fracture clinic in upper limb casts were anonymously surveyed and asked (along with demographics) if they drove while in a cast and if they believed it illegal or covered by insurance to drive. Driving tests of the author wearing upper limb fracture casts were undertaken. The Queensland police traffic branch, the Queensland Department of Transport and the RACQ insurance company were contacted to review the legal and insurance issues involved.

Two-thirds of male and one-third of female patients (half overall) were found to drive while in an upper limb cast. The author failed driving instructor tests in all casts and occupational therapist driving assessments while wearing long arm casts. The author passed occupational therapy driving assessments in left and right short arm casts.

According to these results, a doctor's advice should be to patients not to drive in a long arm upper limb fracture cast and to consider concomitant patient factors when advising patients in short arm casts. Although we do not suggest that patients drive while wearing any cast, we have found a large proportion do. Our limited study has found that a young, fit and pain-free person may be able to drive well enough to pass a driving test while wearing a short arm cast.