Return-to-Work Following Open Reduction and Internal Fixation of Proximal Humerus Fractures
Michael Dietrich*, 1, Mathias Wasmer 2, Andreas Platz 2, Christian Spross 3
1 Department of Orthopaedics, University Hospital Balgrist, Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland
2 Department of Traumatology, City Hospital Triemli Zurich, Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland
3 Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, Rorschacherstr. 95, CH-9007 St. Gallen, Switzerland
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).
Retrospective single-centre study from March 2003 to June 2008.
City hospital, trauma level one centre.
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.
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.
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.
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
* Address correspondence to this author at the Department of Orthopaedics, University Hospital Balgrist, Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland; Tel: +41 44 386 57 66; Fax: +41 44 386 12 90;