Patient and public safety concerns make the timing of return to driving after musculoskeletal injury or orthopaedic surgery an important decision that is made by orthopaedic surgeons on a daily basis. Neither the American Academy of Orthopaedic Surgeons nor any other orthopaedic specialty society has endorsed recommendations, policies, or practice guidelines that address when a patient is able to return to driving after a musculoskeletal injury. To our knowledge, there are no specific guidelines available on how the decision should be made, who should be involved, or to what extent retesting of driving abilities after an injury should be required. The only and most recent guidelines available were developed in 2003 by the National Highway Traffic Safety Administration (NHTSA) in cooperation with the American Medical Association specifically to assess the ability to return to driving in older patients1. While these guidelines address to a limited degree musculoskeletal disability in older individuals, they are not specific to musculoskeletal injury or orthopaedic surgery and they are not entirely applicable to younger age groups. They also fail to incorporate a substantial part of the already limited orthopaedic literature on the topic2-10. The American Occupational Therapy Association (AOTA) is the only organization that has addressed the issue and actually offers Driving and Community Mobility Specialty Certification for occupational therapists who seek the training (www.aota.org). Comprehensive evaluation of driving abilities, as recommended by the AOTA, involves both an office evaluation and a behind-the-wheel assessment administered in a properly equipped test vehicle. Unfortunately, such specialized programs are not standard in conventional occupational therapy practices and are not always geographically or financially accessible to all patients recovering from musculoskeletal injury or orthopaedic surgery.
To address the issue of return to driving in our practice, we formulated a return-to-driving policy that takes …
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