Citation

Latz D, Schiffner E, Schneppendahl J, Hilsmann F, Seiler LF, Jungbluth P, Kaufmann RA, Windolf J, Gehrmann SV. J. Shoulder Elbow Surg. 2019; 28(6): 1139-1145.

Affiliation

Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany.

Copyright

(Copyright © 2019, American Shoulder and Elbow Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jse.2018.11.053

PMID

30770312

Abstract

BACKGROUND: Immobilization of the upper extremity after an acute injury or postoperatively affects an individual's ability to safely operate a motor vehicle. The elbow is particularly sensitive to immobilization, with subsequent stiffness leading to functional limitations. Most activities of daily living are successfully achieved within a "functional arc" of elbow motion between 30° and 130° of flexion. No objective guidelines exist regarding the range of motion needed to safely operate a vehicle. In this study, we measured the range of motion of right and left elbows while driving a manual-transmission car.

MATERIALS AND METHODS: Using electro-goniometers, we measured the flexion and extension, as well as pronation and supination, of the right and left elbows in 20 healthy, right hand-dominant subjects while driving a car. These measurements were recorded on (1) city streets, (2) country roads, and (3) highways.

RESULTS: For city streets, the range of motion in terms of flexion and pronation/supination was 15°-105° and 0°-45°/0°-35°, respectively, for the right elbow and 20°-95° and 0°-45°/0°-40°, respectively, for the left. For country roads, it was 10°-100° and 0°-40°/0°-35°, respectively, for the right elbow and 20°-95° and 0°-30°/0°-30°, respectively, for the left. For highways, it was 5°-100° and 0°-40°/0°-35°, respectively, for the right elbow and 20°-90° and 0°-30°/0°-25°, respectively, for the left. Mean pronation was significantly higher for the right elbow (P < .01).

CONCLUSION: This study describes the range of elbow motion identified to drive a car with a manual transmission and a left-sided steering wheel. Mean pronation of the right elbow is significantly higher than that of the left. Further studies are needed to investigate the relevance of movement restrictions as they relate to handedness, steering-wheel side, and driving impairment.

Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Driving fitness; elbow; forensic medicine; range of motion; traffic medicine; trauma surgery