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Driving Safety

Traffic accidents are a major cause of serious injury and death in America. Every day, orthopaedic surgeons see the horrible aftermath of people who choose to drive while under the influence of alcohol or drugs, or do not wear safety belts.

You can reduce this tragic toll by obeying traffic safety rules, driving defensively, and keeping your vehicle in good mechanical condition. Most important, wear safety belts, do not drink and drive, do not text and drive, and always be aware of how medications you are taking might impact your driving.

Avoid Distractions When Driving

Distracted driving accounts for around 8% of total crashes and 13% of injury crashes. More than 3,200 people were killed and more than 315,000 people were injured in distracted-driving crashes in 2024. 

Distracted driving PSA

A public service announcement from the American Academy of Orthopaedic Surgeons and the Orthopaedic Trauma Association.

Many things can distract people when they are driving. According to the National Highway Traffic Safety Administration (NHTSA), these potentially distracting behaviors include:

  • Texting
  • Talking to other passengers in the vehicle
  • Adjusting the car radio
  • Eating/drinking
  • Making/accepting phone calls
  • Interacting with children who are sitting in the back seat

Texting while driving is one of the most concerning behaviors. In fact, the Governors Highway Safety Association and Cambridge Mobile Telematics report that "drivers with a high level of cell phone distraction are 240% more likely to crash." 

Be aware that distracted driving is a growing problem and is especially dangerous for young drivers. Many states are developing legislation to address distracted driving. Be sure to follow these new laws and use common sense while driving. If you are a parent, enforce strict driving rules for your teenagers.

Do Not Drink and Drive

Whenever you plan to drive, do not drink alcohol. The least destructive result is that you could lose your driver's license. The most serious outcome is that you can kill yourself — or someone else.

Alcohol slows reflexes, impairs coordination, and interferes with concentration. That is why many responsible people use the designated-driver method of road safety. It is simple: one person in your party has only non-alcoholic drinks and is the driver for the night. When hosting a gathering, do not let intoxicated guests drive. Send them home with a friend, in a taxi, or invite them to spend the night.

Understand Your Medications

Understand how medications can affect your ability to drive. Some medications — both prescription and over-the-counter — can cause drowsiness or slow reaction time.

Always read the information that comes with your medication to ensure that it does not cause side effects that could interfere with your ability to drive. Ask your doctor or pharmacist if you are unsure about how a medication might impact your driving.

Use Safety Belts

There are two collisions in every motor vehicle crash. The first occurs when the vehicle strikes an object. However, injury or death more commonly occurs as a result of the second collision, which happens when the driver or passenger collides with the interior of the vehicle or strikes the ground after being thrown from the vehicle.

The best protection for occupants involved in a collision is lap belts and shoulder restraints. In 2024, nearly half of those killed in passenger vehicle crashes were not wearing seat belts. NHTSA estimates that:

  • In passenger cars, wearing seat belts reduces the risk of death by about 45% and of moderate to serious injury by about 50%.
  • In light trucks, wearing seat belts reduces the risk of death by 60% and of moderate to critical injury by 65%.

Excuses for Non-Use

The most common reasons for not using safety belts are based on false assumptions.

  • Myth. Safety belts trap occupants in their vehicles, especially in cases of fire and submersion. I'd be better off if I'm thrown clear.
    Fact. Death by incineration or drowning accounts for less than one-tenth of 1 percent of motor-vehicle-related trauma. Most passengers who are ejected from cars die and the majority of them are thrown out through the windshield.
  • Myth. Safety belts can cause injuries.
    Fact. It is true that injuries due to safety belts have been reported. But in these infrequent cases, the belt was worn incorrectly or the crash was so severe that the occupant would have been more seriously or fatally injured without a safety belt.
  • Myth. Safety belts are important only for long trips and high-speed expressway driving.
    Fact. The majority of traffic crashes happen close to home and at low speeds.

Safety Belts and Pregnant Women

The leading cause of fetal death in a motor vehicle is the death of the mother.

The best protection you can offer your unborn child is to wear a lap and shoulder belt whenever you are on the road. Position the lap belt as low as you can under the "baby bump," and let the shoulder strap rest between your breasts. Wearing both belts in the right position will not increase the chances of damage to the fetus and can keep you both safe.

Safety Belts and Air Bags

Air bags are not a substitute for safety belts. Air bags are designed to inflate only during frontal collisions and are useful only as a supplement to safety belts. However, they offer no protection during multiple crashes, rollovers, or side contact. That is why safety belts must always be worn, even in cars equipped with air bags.

Use Fixed Headrests

Both the NHTSA and the Insurance Institute for Highway Safety report that appropriate head restraints reduce neck injuries related to motor vehicle accidents. Fixed head restraints are nearly twice as effective as adjustable restraints because adjustable head restraints are often left in the down position, where they can't protect someone of average height.

Child Safety Seats

During a crash, a child unrestrained by a safety seat is like a rocket out of control. The child can crash into or through the windshield or violently strike other occupants. Even minor mishaps put children at risk.

Being a safe driver yourself is no excuse for you or your child to be unprotected. The careless act of another driver could injure or kill your children. You increase that chance if you hold your children or allow them to move about in the car unrestrained.

Passenger side air bags alone will not protect children in a crash. Children who are standing or kneeling unrestrained in the front compartment of a vehicle are at risk of injury from the inflating air bag.

Learn more: Child Safety Seats

Why Not Hold a Child in Your Lap?

A child held on an adult's lap has a much greater risk of being injured or killed than a child who is secured in a safety seat. Experts refer to the "on-lap" position as the "child-crusher" position. That is because, in a crash, a child is likely to be crushed between the occupant and the dashboard or the windshield.

Properly Install Child Safety Seats

The law in most states requires that infants and young children be belted into crash-tested safety seats that are appropriate to the child's age and size.

Even the best restraints will not help if they are not properly used. Remember, the safety seat must be secured to the vehicle's seat the way the manufacturer has suggested. Otherwise the safety seat also will become a rocket out of control in a collision. Common mistakes are improper attachment of the restraint to the car or improperly securing the belt around the child.

A child who is accustomed to a safety device from infancy will continue to accept this restriction as a matter of course in later years. As part of their education, children should be permitted to "buckle up" on school buses. The educational and safety benefits of making safety belts available outweigh their costs.

Aging and Driving

As people age, their reaction time slows. Eyesight, particularly at night, decreases, and it may be more difficult to deal with distractions. These changes increase the risk of being in a crash. 

Organizations offer classes in many cities to help mature drivers maintain and improve safe driving habits. For more information, see the American Association of Retired Persons' (AARP) "55 Alive/ Mature Driving Program" or contact your local American Automobile Association's (AAA) club for details on its "Safe Driving for Mature Operators" course.

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.