Return to driving after surgical treatment of proximal humerus fractures.

Introduction: There are few data available about how patients resume car driving after proximal humerus fracture. The aim of this study was to evaluate return to car driving after surgical treatment of proximal humerus fracture. Secondary aims were to identify factors associated with return to driving.

Methods: This retrospective monocentric study included 155 patients (mean age 64.3 ± 11.7 years), operated on for a traumatic proximal humerus fracture. Among them, 59% were treated by ORIF by nail, 18% by ORIF by plate and 23% by a reverse shoulder arthroplasty. All patients had a driver's license and used to drive a car preoperatively, on a regular basis. Modalities for resuming driving after surgery were collected retrospectively. Primary endpoint was the postoperative time to return to car driving. Secondary endpoints were: return to driving rates at 3, 6, 12, 24 months, the time to be back to driving with a shoulder free of pain. Influence of different potential factors on the primary endpoint was evaluated with multivariate analysis. A p-value of less than 0.05 was considered significant.

Results: The 3 groups were comparable with regard to gender, age, medical history, side affected, frequency of pre-operative driving. Postoperative time to return to driving was 15.9 ±11.3 weeks and time to be back to driving with a shoulder free of pain was 31.9 ±13.8 weeks. At 2 years follow-up, 71% of patients had resumed car driving. In multivariate analysis, the following factors were associated with a delayed return to driving: Neer 4 fracture (delayed by 10.2 weeks, p = 0.001); reverse shoulder arthroplasty (delayed by 8.0 weeks, p = 0.02); occurence of a postoperative complication (delayed by 8.9 weeks, p = 0.013). A high SSV score at 3 months was associated with a shortened delay to return to driving (p = 0.035). We did not find any statistical correlation between delay to return to driving and the other potential factors evaluated.

Conclusion: After surgical treatment of proximal humerus fracture, 71% of patients were able to resume car driving, at 2 years follow-up. Mean postoperative time to resume car driving was 15.9 weeks.

Level of evidence: III; retrospective case-control study.