Issue: March 2011
March 01, 2011
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Lower extremity immobilization negatively impacts braking response time

Issue: March 2011
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SAN DIEGO — Orthopedic surgeons should counsel their patients against driving when they wear or have been prescribed certain lower-extremity immobilization devices, according to the results of a prospective observational study presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons, here.

Jeremy K. Rush, MD
Jeremy K. Rush

In addition, patients with their right foot immobilized should steer clear of using a left foot adaptor for braking. The study showed that using the adaptor or wearing immobilization devices significantly increased total brake response time.

Jeremy K. Rush, MD, of Fort Sam Houston, Texas, and colleagues conducted the study.

“Based on the findings from our study, we recommend that no patient should be allowed to drive while immobilized in either a right lower-extremity cast or a CAM boot,” Rush said during his presentation.

Investigators checked 35 healthy volunteers’ braking response time in a driving simulator. The investigators hypothesized that wearing a controlled-ankle-motion (CAM) boot or a prefabricated removable short-leg cast on the right leg or using a left-foot driving adaptor would negatively impact drivers’ ability to stop.

Braking time was measured down to thousandths of a second. Controls consisted of subjects performing the same driving and braking routines, but in normal footwear. The investigators found that the controls consistently outperformed the immobilization group.

“The ability to perform a safe stop is critical to safe driving,” but it is not the only aspect of safe driving, Rush said.

Reference:

  • Rush JK, Orr JD, Dowd TC, et al. The effect of immobilization devices and the left foot driving adaptor on brake response time. Paper #52. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19, 2011. San Diego.

Perspective

I think that is a great paper. We want to hear a paper like that because we want to tell our patients the same thing, but we have no data to back it up. When you did this, you basically gave the patients three trials, and they had to do it 10 times. So, the question is, is three trials enough?

– Steven L. Haddad, MD
Glenview, Ill.
Session moderator

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