Return to driving after a wrist fracture

Susie Stinton, AHTA Accredited Hand Therapist

 

“When can I drive again?” is a common question people ask after they have had after a wrist fracture. Returning to driving with reduced arm function has obvious safety implications. However, not being able to drive is difficult in modern society. It often delays return to work, imposes reliance on friends/family or may lead to social isolation. A fracture of the wrist is a common injury and often occurs after a simple fall.   It can take a long time to recover after wrist fracture. Most improvements happen in the first 2-3 months, but in more severe wrist fractures, it can take up to a year for strength and function to return to normal.

When deciding if return to driving after a wrist fracture is safe, there are two main considerations. The first relates to your physical status. You need to have the movement and strength in your fingers, wrist and arm to grip and turn the steering wheel and shift the gear stick and indicators, and importantly your need to be able to do these tasks quickly in case of an unexpected event on the road. The second consideration is the risk of re-injury during driving. Driving may make your wrist more painful; your fracture may be worsened or healing may take longer if it is not yet able to withstand the forces required during the driving task. There are other medical reasons, such as the use of pain medications where driving is also not recommended.

The research on driving safety after wrist fractures is very limited. There is some evidence to suggest that using a plaster cast or orthosis (splint) for the wrist impairs driving performance, especially if the cast also includes the elbow and/or thumb. Other studies have shown that driving performance worsens after wrist fractures that required surgery, especially in the first 4-6 weeks. A current study at the University of Sydney utilizing data from Western Australia is investigating the risk of being in a car crash when returning to drive following a wrist fracture, with results expected next year.

At this time, there are no distinct rules regarding exact timeframes or circumstances for clearing patients to return to driving after a wrist fracture. Many people will be advised not to drive until the cast is removed and until you are able to use your hand comfortably for other daily functional activities. Return to driving should be discussed on a case-by-case basis, as everyone’s recovery is a little different.

In Australia, driving ‘clearance’ needs to come from a doctor for insurance and/or legal purposes, especially if driving is required for work purposes. However, after temporary injuries, (including most fractures and other hand injuries) there is no legal requirement to report these injuries to the licencing authorities. Your practitioner of hand therapy can guide you as to if you need to discuss driving with your treating doctor.

 

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