January 3, 2011

Stepping on the Brakes After Foot Surgery

(Ivanhoe Newswire) "“ It takes much longer to hit the brakes when wearing an immobilization device, like a splint or a brace, according to this study. Patients recovering from a right foot injury or surgery should think twice before hopping behind the wheel.

Driving is a necessity to most people's lives, so when a person must have their right foot immobilized one of the first questions they ask their orthopedic surgeon 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," CPT Thomas Dowd, MD, an orthopedic surgeon in the Department of Orthopedics and Rehabilitation at Brooke Army Medical Center in Fort Sam Houston, Texas, was quoted as saying. "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."

The researchers found that compared with a person wearing normal footwear, a person traveling at 60 mph would travel an addition 9.2 feet during emergency braking when wearing a right foot controlled-ankle-motion boot. A driver wearing a right lower-extremity short leg cast would travel an additional 6.1 feet before coming to an emergency stop. A driver using a left-foot braking adapter would travel an additional 6.0 feet. When driving a speed of 35 mph, these same individuals would travel an additional 5.4 feet, 3.6 ft, and 3.5 feet, respectively.
These changes in distances traveled could be the difference between avoiding a collision and not avoiding one in an emergency situation. 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 had 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. Orthopedic surgeons need to educate their patients about these safety concerns when discussing the best time to begin driving again."

SOURCE: Journal of Bone and Joint Surgery, published online, January 2011