Review Article When can I drive? Return to driving following a wrist fracture: A critical review Susan B Stinton 1 , Dale W Edgar 2 , Niamh A Moloney 3 , Kathryn Refshauge 4 and Evangelos Pappas 1 Abstract Introduction: The primary aim of this review was to identify literature that examined factors which influence driving performance following a wrist fracture. Given the known scarcity of research in this area, secondary aims were to detail current practices including the driving habits of patients following a wrist fracture and health professionals’ opinions on safe return to driving. Methods: We performed a search in April 2015 using three electronic databases to obtain relevant literature in the English language. Relevant studies including clinical trials, surveys and case reports were reviewed. Results: The search identified 12 relevant studies. Five of these were clinical studies with a crossover design that investigated the driving ability of uninjured individuals with the wrist immobilised in a cast. The remaining were survey- based studies. The clinical trials showed that the presence of a wrist cast reduced driving performance in uninjured individuals. No studies investigated driving performance in individuals with a wrist fracture. The surveys showed that this patient group returns to driving despite perceived safety risks. Inconsistency in expert opinions on whether individuals with a wrist fracture are safe to drive was highlighted. Conclusions: There is evidence to suggest that driving performance is reduced in uninjured individuals when wearing a cast immobilising the wrist; however, the influence of wrist fracture is unknown. This, along with safety implications resulting from current driving behaviours and inconsistent information provided to patients regarding return to driving, highlights the need for further studies to ascertain which factors influence driving performance following wrist fracture. Keywords Wrist, wrist injuries, fracture, automobile driving Date received: 15 April 2015; accepted: 29 June 2015 Introduction Health practitioners are commonly asked by patients at what point ‘it is safe’ to return to driving following a wrist fracture. There is a poor understanding of the clinical factors that may influence the driving capacity in individuals with a wrist fracture. As a result, health professionals may base their responses on radiographic and clinical factors of fracture healing rather than on evidence-based measures of the individuals’ physical capacity to drive safely. Driving a motor vehicle is a complex task requiring a combination of cognitive and physical performance. Drivers need to be able to use the ignition, grip and turn the steering wheel, operate the indicators, gear lever and hand brake consistently, 1 and to be able to do these tasks quickly and accurately in case of an unexpected event. Driving with restricted ability poses obvious risks to the driver and to other road users. Inaccurate advice on driving capacity given to indi- viduals following a wrist fracture could result in people returning to driving before they are safe to do so. If the individual was involved in a motor vehicle accident, negative medico-legal consequences could arise. Conversely, unnecessarily delaying the return to driving 1 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia 2 Fiona Stanley Hospital/Fiona Wood Foundation, Murdoch, WA, Australia 3 Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, NSW, Australia 4 Faculty of Health Sciences and Professor of Physiotherapy, The University of Sydney, Lidcombe, NSW, Australia Corresponding author: Susan B Stinton, Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, 75 East St, O204, Lidcombe, NSW 2141, Australia. Email: s_stinton@outlook.com Hand Therapy 0(0) 1–7 ! The British Association of Hand Therapists Ltd 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1758998315597013 hth.sagepub.com Hand Therapy OnlineFirst, published on July 28, 2015 as doi:10.1177/1758998315597013 by guest on July 29, 2015 hth.sagepub.com Downloaded from