Monday, December 22, 2014
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Driving With a Cast is on Shaky Footing

Is it safe to drive while wearing a cast?

A University of Wisconsin foot-and-ankle specialist who just completed a preliminary study of the question says the answer is clearly no.

Dr. Kurt Rongstad, assistant professor of orthopedic surgery at UW School of Medicine and Public Health, said it's probably the most common question he gets when treating the 300 to 400 of his patients a year who wind up with their right feet in casts or orthotic boots.

After doing a simulated-driving research study on driving with a cast, Rongstad now tells his patients that orthopedic boots or "cam walkers" slow braking time enough that driving while wearing them is unsafe.

He knows this is not the answer they want to hear.

"It is one of the biggest concerns when people are making their post-operative plans," he said. "They want to know how long they'll need a chauffeur to haul them around."

Clearly, no one should drive when taking narcotic pain medication or if driving would disrupt the correct healing of the bones. But what if those conditions don't apply? Rongstad found no laws governing the decision, and searched the medical literature to no avail.

"Usually I like to base my opinions on evidence-based medicine, but there weren't any studies on the topic," he said. So he and Sarnarendra Miranpuri, a fourth-year student at the UW School of Medicine and Public Health, decided to create one.

The timed-reaction study required the 42 subjects to lift their right foot off the gas pedal, move to the brake, and depress the brake pedal after a light flashed. It took about 25 percent longer for them while wearing casts than while wearing regular shoes. Subjects did better if they wore a wedge-type orthopedic shoe commonly used after bunion surgery.

"Clearly and statistically, we found that braking time was inferior with the high or short-leg cam walker," he said.

Rongstad also tested subjects' ability to drive with their left feet--and found that they did better on the test than if they were wearing a cast. But he doesn't think left-foot driving is a safe option for most people, but rather an indication that the driving test needs to be refined.

"I tried driving myself to work and back with my left foot and it was really distracting--like trying to drive while talking on a cell phone," Rongstad said. "Driving is so multifactorial. We drive 90 percent with our brains and 10 percent with our bodies."

Rongstad is waiting for a colleague in the UW School of Engineering to develop a better driving simulator, and then he plans to do his research again to get more refined answers. When all phases of the study are complete he plans to submit his findings to a medical journal.

But for now, Rongstad says, if you're wearing a cast on your right foot, you should be sitting in the passenger seat.

Category: Health




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