Patients Drive Early After Hand Surgery, but is it Smart?

About 50% return to driving within a day of minor hand surgery in a new study; other evidence suggests this may not be very safe

Smart Practice: Left unguided, patients are going to drive within a few days of minor hand surgery — if you’d prefer they not, you’d better speak up.

What’s the Claim?

In a study using daily text messaging to patients after minor hand surgery, 30% returned to driving the same day, about half started driving the next day, three-quarters did so by post-op Day 4, and over 90% returned to driving by the end of the first week. Patients who had wide-awake local anesthesia and those who underwent unilateral hand surgery typically drove within a day of surgery, which was about 3 to 4 days earlier than those who had a general anesthetic or bilateral hand surgery.

How’s It Stack Up?

Obviously this endpoint is likely to be influenced by surgeons’ instructions to their patients; the authors were silent on this point, but we surmise they suggested no restrictions, based on how quickly their patients returned to driving. Return to driving also is likely to be influenced by the size and type of surgery performed. This study evaluated patients who underwent one of five procedures: endoscopic or open carpal tunnel release, trigger finger release, DeQuervain release, and mucous cyst excision, with the largest groups being DeQuervain surgery and open CTR (about 40% and about 25%, respectively).

A Delphi panel study that is freely available in full-text form — use this as a possible surrogate for “standard of care” (since a plaintiff’s attorney just might) — found initial consensus on only two points: it is not safe to drive with a bulky dressing on (90% — surgeons 83%, therapists 100%), and it is safe to drive with a small dressing covering the wound (80% — surgeons 83%, therapists 75%), although after two rounds of debate, the group considered that it’s up to the patient to decide when it’s safe to drive. That same study has a nice figure summarizing those and other areas of consensus, which would make a nice patient handout on the topic.

What’s Our Take?