Background: Proximal humeral fractures (PHF) are a common injury and can result in loss of joint function. Adequate treatment is crucial to fully regain function of the shoulder and with this faster return to work (RTW). Identifying factors that influence RTW after PHF are important to deliver more effective patient care and minimize prolonged work disability. The present study aims to identify the effect of conservative and operative treatment on return to work and recovery.
Materials and methods:In this retrospective case-control study, a total of 858 patients between the ages of 18-68 were treated for a PHF between 2018 and 2021 in Zuyderland Medical Center. Questionnaires (n=342) were sent out to eligible operatively treated patients and 191 matched controls, who were treated conservatively. Questionnaires assessed RTW, quality of life (EQ5D) and functional outcome measures (DASH,ASES). Non-normal distributed data were analyzed using Mann Whitney-U test, and categorical variables were analyzed using Chi-squared test. A Kaplan-Meier analysis was performed for RTW in weeks.
Results: Response rate was 38%. A total of 73 patients (40 OG,34 CG) were included in the data analysis of which 67.1%(49) was female. Prior to trauma, 60% were employed. Almost 70%(n= 19 and 11) of employed patients returned to work, and all patients returned back to their previous jobs. In the OG group, 65.5%(n=14) resumed full-time employment and 41.7%(n= 5) in the CG (p=0.826). Of the patients returning to work, median time in weeks RTW tended to be later for the OG vs CG (OG 10.5, IQR 22 vs. CG 6.00, IQR 8, p=0.072). PROMs showed no statistical difference between groups (p=0.542,p=0.257,and p=0.530, respectively).
Conclusion: While the proportion of patients treated for PHF returning to work was not different between operatively and conservatively treated patients, surgically treated patients tended to return to work 4 weeks later than conservatively treated patients. PROMs did not differ.
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