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Return-to-Work Following Open Reduction and Internal Fixation of Proximal Humerus Fractures

Michael Dietrich, Mathias Wasmer, Andreas Platz & Christian Spross

abstract

OBJECTIVES
Shoulder disorders have an important impact on a patient's capacity to work. We investigated whether there is a relationship between subjective or objective outcome measures and the ability and time for returning to work (RTW) after a proximal humerus fracture (PHF).

DESIGN
Retrospective single-centre study from March 2003 to June 2008.

SETTING
City hospital, trauma level one centre.

INTERVENTION
All PHF stabilized with a PHILOS(®).

MAIN OUTCOME MEASUREMENTS
Routine follow-up examinations (X-ray, Constant-Murley Score (CMS), Short-Form 36 (SF-36)) were performed prospectively after 1.5, 3, 6 and 12 months or until RTW. Primary interest was the comparison of the outcome scores with the time needed for RTW.

RESULTS
72 patients (52 years (22-64), 37 (51%) women) fulfilled the inclusion criteria. We distinguished "office-workers" (OW) (n = 49, 68%) from patients who worked at a physically demanding job (PW) (n = 23, 32%). Although time for RTW was fundamentally different (42 (OW) vs 118 days (PW), p<0.001), CMS (64.7 vs 64.1) and SF-36 (66.8 vs 69.9) at time of RTW were almost identical. At follow-up, CMS and SF-36 were always lower in the PW group.

CONCLUSION
Jobs which require higher physical demands were likely to influence and to delay RTW. This study identifies cut off values for CMS and SF-36 at which a patient feels capable or willing to RTW after PHF. These values show the importance and impact of a patient's occupation or demands on RTW. We were able to show, that besides age, sex and fracture, the type of occupation might alter the scores in postoperative outcomes.
   
citation Dietrich M, Wasmer M, Platz A, Spross C. Return-to-Work Following Open Reduction and Internal Fixation of Proximal Humerus Fractures. Open Orthop J 2014; 8:281-7.
   
type journal paper/review (English)
date of publishing 15-9-2014
journal title Open Orthop J (8)
ISSN electronic 1874-3250
pages 281-7
PubMed 25246994
DOI 10.2174/1874325001408010281
contact Christian Spross