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

A retrospective study of 108 patients

Abstract

Background

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.

Results

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.

Conclusions

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

III.

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Acknowledgments

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.

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Correspondence to A. Aprato.

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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.

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

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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). https://doi.org/10.1007/s12306-016-0430-3

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Keywords

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