title: Effect of surgical shoes on brake response time after first metatarsal osteotomy--a prospective cohort study.
abstract: BACKGROUND
  The aim of this study is to assess patients' driving ability when wearing surgical shoes following right-sided first metatarsal osteotomy.
  
  
  METHODS
  From August 2013 to August 2015, 42 consecutive patients (mean age 54.5 years) with right-sided hallux valgus deformity underwent first metatarsal osteotomy. Patients were tested for brake response time (BRT) 1 day preoperatively (control run) and at 2 and 6 weeks postoperatively. Two different types of foot orthosis were investigated. BRT was assessed using a custom-made driving simulator.
  
  
  RESULTS
  Preoperative BRT was 712 msec (standard deviation (SD), 221 msec). BRT was significantly slower at all tested postoperative times than preoperatively (p < 0.001). The patients showed significant impaired brake response time when wearing surgical shoes. Mean global American Orthopaedic Foot and Ankle Society (AOFAS) outcome score and AOFAS pain and alignment subscores increased postoperatively (p < 0.001).
  
  
  CONCLUSIONS
  From our findings, we recommend driving abstinence for a minimum of 6 weeks postoperatively when using a surgical shoe after bunionectomy. However, patients should have sufficient recovery, exercise, and training before resuming driving a car, because safety is always a priority.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT02354066.
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. dietmar.dammerer@tirol-kliniken.at.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Dammerer
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. matthias.braito@tirol-kliniken.at.
authors.forename: Matthias
authors.initials: M
authors.lastname: Braito
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. rainer.biedermann@tirol-kliniken.at.
authors.forename: Rainer
authors.initials: R
authors.lastname: Biedermann
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. michael.ban@tirol-kliniken.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Ban
authors.affiliation: Department of Psychiatry, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. johannes.giesinger@i-med.ac.at.
authors.forename: Johannes
authors.initials: J
authors.lastname: Giesinger
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. christian.haid@i-med.ac.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Haid
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. michael.liebensteiner@i-med.ac.at.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Liebensteiner
authors.affiliation: Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. gerhard.kaufmann9@chello.at.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kaufmann
mesh_terms: D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology*; D005260:Female; D061826:Foot Orthoses; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods / Q000534:rehabilitation*; D011184:Postoperative Period; D011446:Prospective Studies; D011930:Reaction Time; D020127:Recovery of Function; D012775:Shoes; D055815:Young Adult