title: Driving with a short arm cast in a simulator.
abstract: OBJECTIVE
  To test the ability to steer in a driving simulator in subjects with a short arm cast.
  
  
  METHODS
  17 men and 13 women aged 23 to 67 (mean, 37) years who had a valid driver's licence were randomised to the cast-first group (n=16; 7 had the cast on the dominant arm) or the cast-second group (n=14; 8 had the cast on the dominant arm) and drove in a simulator. A short arm plaster-of-Paris cast was applied in a neutral position, allowing free movement of the metacarpophalangeal joints, thumb, and elbow joint. Outcome measures included the number of driving off track instances, the number of crashes, the lap time, and the effect of hand dominance on these parameters. Subjects were asked whether the cast had impeded their steering ability.
  
  
  RESULTS
  Subjects with or without a cast were comparable in terms of the number of driving off track instances, number of crashes, and lap time. Compared with no cast, the odds ratio (OR) of a subject in a cast driving off the track was 1.02 (p=0.921) and having a crash was 0.79 (p=0.047). All subjects were 1.23 times more likely to drive off the track in their first lap (OR=2.66, p=0.019). The mean lap time decreased for each consecutive lap from the 2nd to 5th laps. Subjects driving with a cast on the dominant or non-dominant arm were comparable. 26 out of the 30 participants considered that the plaster cast impeded their steering ability.
  
  
  CONCLUSIONS
  Compared with no cast, driving with a short arm cast did not significantly decrease steering ability in a driving simulator.
authors.affiliation: Department of Orthopaedics, John Hunter Hospital, Newcastle, Australia.
authors.forename: Damian
authors.initials: D
authors.lastname: Mansour
authors.affiliation: Department of Paediatrics, John Hunter Hospital, Newcastle, Australia.
authors.forename: Kristin Gotaas
authors.initials: KG
authors.lastname: Mansour
authors.affiliation: Department of Orthopaedics, John Hunter Hospital, Newcastle, Australia.
authors.forename: Benjamin William
authors.initials: BW
authors.lastname: Kenny
authors.affiliation: Hunter Medical Research Institute, Newcastle, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.affiliation: Department of Orthopaedics, John Hunter Hospital, Newcastle, Australia.
authors.forename: Bryce
authors.initials: B
authors.lastname: Meads
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D001334:Automobile Driving; D002370:Casts, Surgical; D003198:Computer Simulation; D004551:Elbow Joint; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D055815:Young Adult
keywords: arm injuries; automobile driving; casts, surgical; upper extremity