Skip to main content

Are work return and leaves of absence after acetabular fractures predictable?

A retrospective study of 108 patients



To test if complexity of acetabular fractures, pre-trauma health status, time from trauma to definitive surgery, severity of injury or job characteristics influence work resumption, return to the same professional position and time out of work.

Materials and methods

We performed a retrospective study on patients with surgically treated acetabular fractures. Medical records were reviewed to analyse demographics, follow-up, diagnosis (Letournel classification), type of surgical treatment, co-morbidities, time from trauma to definitive surgery, American Society of Anesthesiologists physical status classification (ASA) and associated injuries. Patients were interviewed about the amount of leaves of absence and whether they returned to the same professional position.


The study included 108 patients whose mean age was 44 ± 11 years. Median time out of work was 180 days. Eleven patients lost their job and 23 patients returned to a different professional position. Univariable analysis showed: (a) the risk of losing the job was higher for patients who had been admitted to intensive care unit (ICU) (p = 0.018), (b) returning to the identical position was more likely in patients who were older (p = 0.006), sedentary workers (p = 0.003), and with shorter time from trauma to definitive surgery (p = 0.003). Multivariable linear regression showed that leaves of absence were longer in patients with higher ASA scores, who had been admitted to ICU, or were not sedentary workers.


Work reintegration after acetabular fractures is a main issue for the patient and social systems: only 69 % of patients returned to their previously held professional position. Time out of work was not found to be related to fracture type but to pre-trauma health status, ICU admission and sedentary jobs.

Level of evidence


This is a preview of subscription content, access via your institution.


  1. 1.

    Giannoudis PV, Grotz MR, Papakostidis C et al (2005) Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br 87:2–9

    CAS  PubMed  Google Scholar 

  2. 2.

    Aprato A, Joeris A, Tosto F et al (2015) Are work return and leaves of absence predictable after an unstable pelvic ring injury?”. J Orthop Traumatol. doi:10.1007/s10195-015-0379-2

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    Judet R, Judet J, Letournel E (1964) Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 46:1615–1646

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Saklad M (1941) Grading of patients for surgical procedures. J Anesth 2:281–284

    Article  Google Scholar 

  5. 5.

    Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 1988(70):1–12

    Google Scholar 

  6. 6.

    Giannoudis PV, Nikolaou VS, Kheir E et al (2009) Factors determining quality of life and level of sporting activity after internal fixation of an isolated acetabular fracture. J Bone Joint Surg Br 91:1354–1359

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Childs BR, Vallier HA (2014) Cost savings associated with a multidisciplinary protocol that expedites definitive fracture care. Am J Orthop (Belle Mead NJ) 43:309–315

    Google Scholar 

  8. 8.

    Curtis K, Lam M, Mitchell R et al (2014) Major trauma: the unseen financial burden to trauma centres, a descriptive multicentre analysis. Aust Health Rev 38:30–37

    Article  PubMed  Google Scholar 

  9. 9.

    Nahm NJ, Moore TA, Vallier HA (2014) Use of two grading systems in determining risks associated with timing of fracture fixation. J Trauma Acute Care Surg. 77:268–279

    Article  PubMed  Google Scholar 

  10. 10.

    Stergiannis P, Katsoulas T, Fildissis G et al (2014) Health-related quality of life and rehabilitation cost following intensive care unit stay in multiple trauma patients. J Trauma Nurs 21:115–121

    Article  PubMed  Google Scholar 

  11. 11.

    Tufescu TV, Buckley R (2001) Age, gender, work capability, and worker’s compensation in patients with displaced intraarticular calcaneal fractures. J Orthop Trauma 15:275–279

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Vallier HA, Cureton BA, Ekstein C et al (2010) Early definitive stabilization of unstable pelvis and acetabulum fractures reduces morbidity. J Trauma 69:677–684

    Article  PubMed  Google Scholar 

  13. 13.

    Plaisier BR, Meldon SW, Super DM et al (2000) Improved outcome after early fixation of acetabular fractures. Injury 31:81–84

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    MacKenzie EJ, Morris JA, Jurkovich GJ et al (1998) Return to work following injury: the role of economic, social, and job-related factors. Am J Public Health 88:1630–1637

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Kay HF, Sathiyakumar V, Yoneda ZT et al (2014) The effects of American Society of Anesthesiologists physical status on length of stay and inpatient cost in the surgical treatment of isolated orthopaedic fractures. J Orthop Trauma 28:e153–e159

    Article  PubMed  Google Scholar 

  16. 16.

    Burton AK, Kendall NA, Pearce BG et al (2009) Management of work-relevant upper limb disorders: a review. Occup Med (Lond) 59:44–52

    Article  Google Scholar 

Download references


The authors thank all the AOCID (AO Clinical Investigation and Documentation) staff for the help in preparing the manuscript. The corresponding author was supported by the AO foundation via an AO Trauma fellowship at AOCID.

Author information



Corresponding author

Correspondence to A. Aprato.

Ethics declarations

Conflict of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments. The study was approved by the responsible Ethical Committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Aprato, A., Joeris, A., Tosto, F. et al. Are work return and leaves of absence after acetabular fractures predictable?. Musculoskelet Surg 101, 31–35 (2017).

Download citation


  • Acetabulum
  • Internal fracture fixation
  • Leaves of absence
  • Morbidity
  • Return to work