Ankle fractures: When can I drive, doctor? A simulation study.

Area of Science:

• Orthopedics
• Traumatology
• Rehabilitation Medicine

Background:

• Traumatic ankle fractures are common, frequently raising patient concerns about returning to driving.
• Assessing the return of safe driving capabilities, particularly braking force and reaction time, is crucial but often unaddressed.
• Previous literature lacks specific data on the recovery of braking force post-ankle fracture.

Purpose of the Study:

• To pilot the assessment of motor power (braking force) and visual reaction time in patients with ankle fractures using a driving simulator.
• To establish normal parameters for these functions using the non-injured contralateral limb as a baseline.
• To provide objective data to inform return-to-driving decisions.

Main Methods:

• A sample of 12 drivers with isolated right ankle fractures was recruited after fracture union and removal from plaster.
• The Drive Test Station (DTS) was employed to measure maximum brake pedal force and visual reaction time.
• Normal parameters were established using the patient's uninjured limb.

Main Results:

• Patients achieved an average maximum brake pedal force of 34.4 kg, close to the required 35 kg for emergency stops.
• No statistically significant difference (p>0.05) was found in total visual reaction time or visual pathway reaction time between the injured and non-injured limbs.
• The DTS proved effective in simulating emergency braking and assessing cognitive function.

Conclusions:

• The Drive Test Station (DTS) is a practical tool for assessing motor power and cognitive function in patients recovering from ankle fractures.
• Objective data from the DTS can help patients and clinicians gauge readiness for return to driving.
• While the DTS provides valuable insights, clinical judgment remains essential for final return-to-driving recommendations due to medicolegal considerations.