Sansosti Laura E, Greene Timothy, Hasenstein Todd, Berger Michael, Meyr Andrew J
Resident, Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.
Clinical Associate Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.
J Foot Ankle Surg. 2017 May-Jun;56(3):522-542. doi: 10.1053/j.jfas.2017.01.022. Epub 2017 Mar 1.
The effect of lower extremity pathology and surgery on automobile driving has been a topic of contemporary interest, because these conditions can be associated with impaired driving function. We reviewed the U.S. driving laws relative to foot and ankle patients, for the 50 U.S. states (and District of Columbia). We aimed to address the following questions relative to noncommercial driving regulations: does the state have regulations with respect to driving in a lower extremity cast, driving with a foot/ankle immobilization device, driving with acute or chronic lower extremity pathology or disability, those who have undergone foot and/or ankle surgery, and those with diabetes? Full state-specific answers to the preceding questions are provided. Most states had no explicit or specific regulations with respect to driving in a lower extremity cast, a lower extremity immobilization device, or after foot and/or ankle surgery. Most states asked about diabetes during licensing application and renewal, and some asked specifically about lower extremity neuropathy and amputation. Most did not require physicians to report their patients with potentially impaired driving function (Pennsylvania and Oregon excepted) but had processes in place to allow them to do so at their discretion. Most states have granted civil and/or criminal immunity to physicians with respect to reporting (or lack of reporting) of potentially impaired drivers. It is our hope that this information will be useful in the development of future investigations focusing on driving safety in patients with lower extremity dysfunction.
下肢疾病及手术对汽车驾驶的影响一直是当下人们关注的话题，因为这些情况可能与驾驶功能受损有关。我们查阅了美国50个州（及哥伦比亚特区）与足踝患者相关的驾驶法规。我们旨在针对非商业驾驶规定回答以下问题：该州对于下肢打石膏驾驶、使用足踝固定装置驾驶、患有急性或慢性下肢疾病或残疾驾驶、接受过足踝手术的人驾驶以及糖尿病患者驾驶是否有相关规定？文中提供了各州针对上述问题的具体答案。大多数州对于下肢打石膏驾驶、使用下肢固定装置驾驶或足踝手术后驾驶没有明确或具体的规定。大多数州在驾照申请和换证时会询问糖尿病情况，有些州还会特别询问下肢神经病变和截肢情况。大多数州不要求医生报告其可能存在驾驶功能受损的患者（宾夕法尼亚州和俄勒冈州除外），但有相应程序允许医生自行决定是否报告。大多数州在医生报告（或不报告）潜在驾驶功能受损者方面给予了民事和/或刑事豁免权。我们希望这些信息将有助于未来开展针对下肢功能障碍患者驾驶安全的调查。
