title: Emergency brake response time after first metatarsal osteotomy.
abstract: BACKGROUND
  There is sparse information upon which to recommend a return to activity after foot surgery. The purpose of this study was to determine whether six weeks is sufficient time for the emergency brake response time to return to preoperative levels after a first metatarsal osteotomy for symptomatic hallux valgus.
  
  
  METHODS
  We conducted a prospective, observational study to assess the effect of surgery on emergency brake response time in a group of twenty-eight patients undergoing a unilateral first metatarsal osteotomy on the right side for symptomatic hallux valgus. A custom-made driving simulator was used to assess total brake response time, reaction time, and brake time. Patients were assessed preoperatively and at two and six weeks postoperatively. A control group of twenty-eight individuals matched for age, driving status, and sex was included for baseline comparison.
  
  
  RESULTS
  Total brake response time, reaction time, and brake time were significantly lower for the control cohort compared with the preoperative values recorded in the study cohort (p < 0.05). Only seven of the twenty-eight study patients were able to complete the assessment at two weeks; the remainder were not able to complete it because of postoperative pain. All patients were able to comfortably complete the study at six weeks. In the study cohort, the total brake response time, reaction time, and brake time had significantly improved compared with preoperative recordings (p < 0.05).
  
  
  CONCLUSIONS
  By six weeks after surgery, emergency braking time in patients undergoing a first metatarsal osteotomy is similar to that of healthy individuals.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Holt
authors.forename: M
authors.initials: M
authors.lastname: Kay
authors.forename: R
authors.initials: R
authors.lastname: McGrory
authors.forename: C S
authors.initials: CS
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001334:Automobile Driving; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D011930:Reaction Time; D020127:Recovery of Function; D013997:Time Factors