Are you one of those people who wonders if you can drive a car after a lower limb fracture or surgery (ankle, leg, knee and foot)?
In this article we shall be examining what the law says, studies and practical advice about driving.
I am a diagnostic radiographer, and my patients ask me this question very often after taking their x-ray.
I have compiled in this article all the information that I consider useful so that you know better in your case when you can drive again or not.
⚪Both on the regulatory level here in the United Kingdom /NHS
⚪ But above all in relation to your ability to drive safely for yourself and others on the road.
All references at the end of this article.
Happy reading!😀
Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏
Last updated: Oct 2024. Written by Juliet Semakula, diagnostic radiographer.
Disclaimer: no affiliate links.
▶️Why ask when to drive after a fracture or surgery of the lower limb?
Deciding when to drive after a fracture is difficult whether you have a splint, cast or you have had surgery.
You may feel pain when doing certain movements or positions whether you have multiple injuries or not. The reason being the rate of healing and recovery will vary by patient.
The decision to resume driving after orthopaedic injury or surgery requires important legal and safety considerations.
That’s why you always want to find out whether it is safe to drive again especially when you still feel some discomfort after treatment.
I have seen patients drive without consulting a doctor or physiotherapy. The truth is even surgeons, physiotherapy and doctors I speak to, do not have clear guidelines on when someone could resume driving.
What do they believe:
They believe it is good to resume driving when you are no longer immobilised and you have resumed full weight bearing, or full grip strength in both your legs and hands.
Caution! While doctors can advise you about whether you’re ready to operate a vehicle, their opinion doesn’t hold any legal force.
Let’s first see what the law and NHS in the United Kingdom regulations say on the subject.
▶️ What does the law say about returning to driving after a broken lower limb (Tibia and fibula, ankle, knee or foot) with or without surgery.
Here in the United Kingdom, it is the Driver and Vehicle Licensing Agency (DVLA) which dictates whether one has the right to drive.
They advise you to tell DVLA if you’ll be unable to drive for more than 3 months because of a broken limb.
You can be fined up to £1,000 if you don’t tell them and you may be prosecuted if you’re involved in an accident as a result.
Basically, it is up to you to determine if you are fit to drive or not. Or you are insured to drive.
▶️Can you legally drive with a splint or cast?
The driver vehicle licensing agency does not say anything particle or specific in the United Kingdom regarding not to drive with a cast but the national health system (NHS) in the UK highlights:
Is it legal to drive with a cast or walking boot or immediately when it has been removed?
Having a cast or walking boot on or having it removed may not enable you to drive as soon as you may want.
Here are some of their reasons why you are not allowed to drive with a cast or walking boot on or immediately when it is removed.
🔵After your boot has been removed due to the long period of time your limb has been immobilised, you may find that your leg feels thin and strange which is normal but not ok yet to drive.
🔵You may experience swelling, discomfort and stiffness in the affected limb. This is quite normal and may continue for several weeks.
🔵You may find it helpful to keep the limb elevated to allow quick recovery.
🔵Driving should be avoided during the first few weeks after your boot has been removed.
▶️ What do medical studies and surveys say about resuming driving after a fracture or surgery.
The decision to drive after a fracture is a challenging one, a few guidelines and studies are available to help us understand the importance of safety on the road and when we can drive after treatment.
A survey of some British surgeons’ research compiled a percentage of scenarios involving lower extremity fractures and here is what they found:
Among the 61% patients with lower leg follow up fractures that were observed. They believed that full weight bearing in the lower extremity was a commonly cited criterion for fitness to drive
For those who have had ankle fractures these were the acceptable time frame for driving.
Acceptable braking function is achieved 2 weeks after cast removal for nonsurgical managed ankle fracture,
When you have had surgery, 9 weeks after surgery for an ankle fracture you may be able to brake without feeling pain and 18 weeks after surgery for an articular fracture.
Although one study suggested waiting 12 weeks after surgery in patients with long bone fractures, 9 weeks appears sufficient to achieve acceptable braking function after this injury.
Most surgeons I speak too, agree that full weight bearing is essential to driving clearance when you have fractured your lower leg and it is best to wait until you have completed all your follow-ups checks.
▶️How long does it take to drive again after a broken lower limb?
You will be ultimately responsible for the decision to drive. You will know that it is ok to drive again basing on how you feel with your injury and how safely you can move the car:
In a review of 48 studies covering 20 common orthopaedic procedures, researchers at the University of Maryland made the following observations:
⏩For ankle fracture treated operatively, normal function was usually restored at 9 weeks postoperatively and 7 days after the cast was removed.
⏩For post-operative total knee replacement fractures normal Braking function was usually restored at 2 to 8 weeks after knee arthroscopy.
⏩For foot fracture, reported a return to driving at 6 weeks when treated with a walking boot and 12 weeks after injury when treated with a short leg cast
⏩For post-operative tibial and femur fractures normal braking time function had significantly improvement at 6 weeks after initiation of weight bearing therapy.
Here are some predictions of recommendations from the literature I was able to view.
| Procedure (lower limb) | Returning to driving |
| Total ankle arthroplasty | 6 weeks |
| Post-operation tibial & femur | 6 weeks after weight bearing therapy. |
| Soft tissue foot & ankle injury | 2 to 7 weeks |
| Foot & Big toe Hallux vaugus correction | 6 to 8 weeks |
| Ankle arthrodesis | 6 to 12 months |
| Treated ankle fracture | 2 to 6 weeks and 3 to 4 weeks for conservatively managed ankle fractures, out of cast |
| Cast immobilisation | Conflicting evidence – avoid driving if right sidecasted versus no recommendations given |
| Achilles tendon repair | Between 6 to 7 weeks |
| Below-knee cast | It is advised that you are not safe to drive unless you arewearing a left leg cast with automatic transmission. |
| Ankle fractures/open reduction internal fixation | It’s advised to return to driving around 6 to 9.7 weeks for operativelymanaged tibial fractures depending on weight-bearingstatus. 6 weeks for operatively treated ankle fractures |
| Total knee prosthesis | Left knee from 0 to 3 months: Right knee 2 to 8 weeks |
| Hip replacement | From 6 weeks, right hip replacement 6 days to 8 weeks |
| Medullary centre nail on the tibia or femur on the right | 12 weeks (6 weeks after support is authorised). |
| Rotator cuff operated arthroscopically | 12 weeks (1 day to 4 months) |
| Partial knee meniscectomy | Left: most often no deadlines: right :1 day to 3 weeks |
The time limits indicated for driving again after an operated fracture or surgery, in the publication of MacKenzie et al. 2018 and Khaliq et al.2023
▶️What is the risk of driving too soon after a lower limb fracture?
🟡According to the United Kingdom driving regulations and NHS guidelines, your insurance may not be valid whilst you are being treated within a boot.
If you return to driving after an injury or surgery, you may need to check with your insurance company to ensure they’re satisfied that you’re able to drive safely.
Caution! Many insurance companies may not cover you if you’re in an accident while wearing a cast or brace.
🟡It is stressed firmly that patients DO NOT drive whilst wearing a boot because of safety reasons.
Safety: A walking boot can limit your ability to operate the pedals effectively. If you cannot use the brake and accelerator pedals with full control, it’s safer not to drive.
Comfort and Mobility: Consider how comfortable you feel manoeuvring the vehicle. If you have any doubts about your ability to drive safely, it’s best to avoid it.
▶️How do I know if it’s okay to drive again?
In general, the green light to drive again after lower leg fractures is given at the latest during the follow-up visit with your surgeon. Around 2 months after your fracture
The lack of guidance could result in you being withheld from driving for longer than is necessary or returning to driving while still unsafe.
You are ultimately responsible for the decision to drive. You will know that it is ok to drive again:
Some people decide to resume driving earlier, around 2 to 3 months after the treatment.
🟡You must be able to move your neck, spine, shoulder, elbow, wrists, knees, ankles, and feet without feeling pain or stiffness.
If your pain comes and goes, it’s still dangerous because a sudden, unexpected twinge can cause you to swerve, apply more pressure on the gas, or become distracted.
If your movements are impaired because of braces or stiffness, your reaction time will be much slower when trying to brake.
🟡 If you can stop or be able to brake in an emergency stop without feeling pain or stiffness in your leg.
🟡Be able to shift all gears including reverse.
🟡Pressing the brake, clutch and accelerator pedals quickly.
Sit for a few minutes as well
If everything is ok, then you can consider driving on a short trip, about 15 minutes then gradually increase the time spent driving.
Summary: the journey to recovery from surgery or any fracture injury is unique. Guidelines in this article highlights views of different studies on how long it can take to return to driving after different types of surgeries.
But in the end, you will need to decide based on your personal needs and abilities.
You could check yourself after you have driven in the days that follow if your pain is the same as normal.
Understanding the advantages of going back to driving a car such as giving you an opportunity to return to your normal life and being able to do more activities.
A fair balance between too much and too little precaution when deciding when to resume driving should be considered
We have come to the end of this article, wishing you quick recovery! 🙋
Hope I have been able to answer some of your questions.
📚Sources:
MacKenzie JS, Bitzer AM, Familiari F, Papalia R, McFarland EG. Driving after Upper or Lower Extremity Orthopedic Surgery. Seals. 2019 Feb 1;6(4):232-240. doi: 10.1055/s-0039-1678562 . PMID: 31879720; PMCID: PMC6930129.
Khaliq M, Giannoudis VP, Palan J, Pandit HG, van Duren BH. Return to driving post upper or lower extremity orthopaedic surgical procedures: a scoping review of current published literature. EFORT Open Rev. 2023 Dec 1;8(12):936-947. doi: 10.1530/EOR-23-0117. PMID: 38038382; PMCID: PMC10714384.
Marecek GS, Schafer MF. Driving after orthopaedic surgery. J Am Acad Orthop Surg. 2013 Nov;21(11):696-706. doi: 10.5435/JAAOS-21-11-696. PMID: 24187039.
MacLeod, K., Lingham, A., Chatha, H., Lewis, J., Parkes, A., Grange, S., & Smitham, P. J. (2013). “When can I return to driving?”. The Bone & Joint Journal, 95-B(3), 290-294. https://doi.org/10.1302/0301-620X.95B3.29540
Disilvestro KJ, Santoro AJ, Tjoumakaris FP, Levicoff EA, Freedman KB. When can I drive after orthopaedic surgery? A systematic review. Clin Orthop Relat Res. 2016;474(12):2557-2570. doi:10.1007/s11999-016-5007-9