Duration of incapacity of work after tibial plateau fracture is affected by work intensity

Abstract

BackgroundTibial plateau fractures requiring surgery are severe injuries of the lower extremity. Tibial plateau fractures have an impact not only on physically demanding jobs but notably on general professional life too. The aim of this study was to assess how the professional activity of patients will be affected after a tibial plateau fracture.Methods39 consecutive patients (ages 20–61 years) were retrospectively included in the study and were clinically examined at a minimum of 14 month postoperatively. Inclusion criteria were surgical treatment of tibial plateau fractures between November 2009 and December 2012. The clinical evaluation included the Lysholm score and the Oxford Knee Score. Fractures were classified and analyzed using the AO classification. Intensity of work was classified as established by the REFA Association. The patients themselves provided postoperative duration of the incapacity of work and subjective ratings.Results17 (43.6%) women and 22 (56.4%) men were examined with a mean follow-up of 29.7 ± 10.4 months (range 14–47). According to the AO classification there were 20 (51.3%) B-type-fractures and 19 (48.7%) C-type-fractures. The median incapacity of work was 120 days (range 10–700 days) with no significant differences between B- and C-type-fractures. Four (10.3%) patients reduced their working hours by 10.5 h per week on average. Patients with low workload (REFA 0–1, median incapacity of work 90 days, range 10–390 days) had a significant shorter incapacity of work than patients with heavy workload (REFA 2–4, median incapacity of work 180 days, range 90–700 days) (p < 0.05). The median Lysholm score decreased significantly from 100 points (range 69–100) before the injury to 73 points (range 23–100) at the time of the follow-up. All patients received postoperative physiotherapy (median 25 appointments, range 6–330), with a significant higher number of appointments for C-type-fractures than for B-type-fractures (p = 0.004).ConclusionA relationship was found between workload and the duration of incapacity of work after tibial plateau fractures. The post-injury shift to less demanding jobs and the reduction of working hours highlight the impact of a tibial plateau fracture on a patient’s subsequent physical ability to work.

Disability and Pain are the Best Predictors of Sick Leave After a Distal Radius Fracture in Men

“…A commonly held belief is that high work demand and more severe fracture lead to prolonged sick leave [5,6], whereas we hypothesize that patient perception also plays a key role. The aim of the present study is to describe the variation in sick leave among men with distal radius fracture and most importantly to explore the impact of patient-related factors such as self-reported disability and pain, in addition to fracture related variables.…”

Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus

“…The following 14 independently factors that might possibly affect the postoperative results of patients with symptomatic DLM were collected from the patients’ medical records, imaging data and arthroscopy videos: sex; BMI (kg/m 2 ); work intensity (based on‘REFA daily life and work intensity classification’ [ 18 ], schedule 1); trauma history (clinical symptoms of knee joints due to sports, sprains, falls, etc. ); involved knee joint (left or right); age of onset; duration of symptoms; DLM type according to the Watanabe Classification [ 17 ], schedule 2; type of DLM tear (based on the O’Connor classification of meniscus tears [ 19 ], schedule 3); medial meniscus tear; severity of cartilage lesion classified according to Outerbridge grade [ 20 ], schedule 4; Kellgren-Lawrence classification of osteoarthritis grade [ 21 ] (K-L grade, schedule 5); method of surgery (saucerization, saucerization with repair, total meniscectomy); and final follow-up time.…”

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

“…The following 14 independently factors that might possibly affect the postoperative results of patients with symptomatic DLM were collected from the patients' medical records, imaging data and arthroscopy videos: sex; BMI (kg/m 2 ); work intensity (based on'REFA daily life and work intensity classi cation' [29], schedule 1); trauma history (clinical symptoms of knee joints due to sports, sprains, falls, etc. ); involved knee joint (left or right); age of onset; duration of symptoms; DLM type according to the Watanabe Classi cation [28], schedule 2; type of DLM tear (based on the O'Connor classi cation of meniscus tears [42], schedule 3); medial meniscus tear; severity of cartilage lesion classi ed according to Outerbridge grade [40], schedule 4; Kellgren-Lawrence classi cation of osteoarthritis grade [41] (K-L grade, schedule 5); method of surgery (saucerization, saucerization with repair, total meniscectomy); and nal follow-up time.…”