Abstract
INTRODUCTION
Hallux Valgus is a common foot condition, which may affect mobility and lifestyle. Corrective surgery is performed as a day case procedure, however, post-operatively; patients remain limited in their ability to drive for a variable period. In the laboratory settings, emergency brake response time after first metatarsal osteotomy has been studied but there is no published study of patients’ experience of driving after this surgery. This study was aimed at assessing patients’ driving ability and comfort after Hallux Valgus corrective surgery.
METHODS
Fifty consecutive patients who underwent first metatarsal corrective osteotomy from January 2009 to July 2010 were reviewed. The operation type, foot side operated, postoperative complications and other conditions affecting driving were recorded from charts and operation notes. A telephonic survey was then conducted and information was recorded in a predesigned questionnaire. The questions included driving advice given by the medical staff, time interval to begin driving postoperatively, and how long the patient took to gain full confidence at driving. It was also noted whether patients required changing the type of car from manual to automatic.
RESULTS
Of 50 patients, 10 never drove and were excluded. One patient had expired from unrelated health conditions. Two discontinued driving after surgery due to other (social) reasons, and one could not be contacted. The remaining thirty-six patients were analyzed. The mean age was 56.8+/-9.8 years with range of 36–74 years. Most were females (n=33, 91.7%), and the right side was operated upon in 17 (44.4%) patients. SCARF osteotomy was performed in 19 (52.8%) patients, basal osteotomy in 5 (13.9%), chevron osteotomy in 5 (13.9%) and other procedures (bunionectomy, Akin, soft tissue correction etc) were done in 7 (19.4%) patients.
Out of the 28 patients driving manual cars, one required changing to automatic vehicle. The average post-operative period when patients resumed driving was 8.6 weeks with a range of 4 to 16 weeks. After SCARF, this average was 8.3 weeks (range 6–16), which was against 7.6(range 6–16) and 7.8 (range 4–12) weeks after basal and chevron procedures respectively (p=0.408).
The mean period when patients reported comfortable foot control was 1.06 weeks after they had begun to drive for all groups. With SCARF this was 1.3 weeks, and 1.4 and 2.2 for basal and chevron groups respectively (p=0.162).
Of the two patients that resumed driving after 16 weeks, one had infection and swelling of the foot postoperatively and the other had bilateral basal osteotomy performed simultaneously and was on crutches for 16 weeks.
CONCLUSION
The mean time to resumption of automobile driving after corrective Hallux Valgus surgery is 8.6 weeks, and, on average patients takes another week to attain full confidence and comfort at driving postoperatively. There is no statistically significant difference between the types of surgery performed.
