Objective:

The purpose of this study is to investigate the ability and safety of driving with commonly used upper limb casts, and to determine the effect of hand dominance.

Material and Methods:

Two healthy drivers, one of them right-handed and the other left-handed (confirmed with the Edinburgh handedness inventory), were selected. The vehicles used in this study were the 2006 model Volkswagen Golf with a manual-geared right-hand drive with power steering and the 2004 model Honda Civic with an automatic-geared right-hand drive with power steering. We assessed driving ability and safety whilst wearing a scaphoid cast and a Colles cast. Initially, a 20-min driving circuit was completed without immobilisation by each volunteer on a track which was closed to traffic. Six essential driving abilities, namely steering and turning, reversing, gear changing and panel control were assessed subjectively by the drivers. Each of the driving abilities was scored between 0 and 10 points. Each score acquired from the relevant section was added to obtain a total score. Scores taken from each section and the total scores were compared in terms of plaster cast type, gear option, body side and dexterity.

Results:

Driving scores were statistically similar regarding dexterity and gear option in total and section scores (p=0.878, p=0.442). A difference between the Colles cast and the scaphoid cast was only observed in panel control (p=0.010). Immobilisation of the left hand significantly decreased the total score (p=0.001); however, gear shifting and panel control sections were similar between body sides (p=0.105 and p=0.442, respectively). All scores obtained from each section were significantly lower compared to controlled driving (p=0.000).

Conclusion:

Driving with an upper limb cast is unsafe; furthermore, immobilisation of the non-dominant hand does not satisfy the necessary requirements for safe driving. We should discourage patients and warn them about the dangers of driving when wearing an upper limb plaster cast.

Keywords: Driving, fracture, motor car, plaster cast, upper limb