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

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.