On the Road Again: Return to Driving Following Minor Hand Surgery

Abstract

Background: Patient return-to-driving following minor hand surgery is unknown. Through daily text message surveys, we sought to determine return-to-driving after minor hand surgery and the factors that influence return-to-driving.

Methods: One hundred five subjects undergoing minor hand surgery received daily text messaging surveys postoperatively to assess: (1) if they drove the day before and if so; (2) whether they wore a cast, sling, or splint. Additional patient-, procedure-, and driving-related data were collected.

Results: More than half of subjects, 54 out of 105, returned to driving by the end of postoperative day #1. While patient-related factors had no effect on return-to-driving, significant differences were seen in anesthesia type, procedure laterality, driving assistance, and distance. Return-to-driving was significantly later for subjects who had general anesthetic compared to wide awake local anesthetic with no tourniquet (4 ± 4 days vs 1 ± 3 days, P = 0.020), as well as for bilateral procedures versus unilateral procedures (5 ± 5 days vs 1 ± 3 days, P = 0.046). Lack of another driver and driving on highways led to earlier return-to-driving (P = 0.040 and, P = 0.005, respectively).

Conclusions: Most patients rapidly return to driving after minor hand surgery. Use of general anesthetic and bilateral procedures may delay return-to-driving. Confidential real-time text-based surveys can provide valuable information on postoperative return-to-driving and other patient behaviors.

Keywords: anatomy; anesthesia; carpal tunnel syndrome; diagnosis; hand; nerve; outcomes; rehabilitation; research & health outcomes; specialty; surgery; thumb; wrist.

Figure 1.

Screening, enrollment, and text survey flow chart. Text message survey responses are indicated by “Y” for yes and “N” for no.

Figure 2.

Distribution of patient-reported return-to-driving. Histogram demonstrates distribution of when patients return to driving following minor hand surgery (trigger finger release, open carpal tunnel release, endoscopic carpal tunnel release, de Quervain’s release, or cyst excision).

Figure 3.

Significant procedure-related factors on return-to-driving after minor hand surgery. Note. Bar graph demonstrates the median return-to-driving day for type of anesthetic and operative hand(s). Error bars illustrate interquartile range of each variable. *Significant findings of P < 0.05 are demonstrated with a red asterisk between general anesthesia (GA) versus wide awake local anesthetic no tourniquet (WALANT) and bilateral versus unilateral procedures.