Predictors of time lost from work following a distal radius fracture.

STUDY

DESIGN

Prospective Cohort.

OBJECTIVE

to describe time lost from work following a distal radius fracture.

METHOD: A cohort of 227 workers with distal radius fracture was enrolled at a baseline visit to the hand clinic where injury, patient characteristics, and occupational demand were recorded. Patients were followed up at 2, 3, 6, and 12 months and self-reported time lost from work, disability (PRWE, DASH), and health (SF-36). Impairments of grip strength, wrist motion and dexterity were measured at 2 and 3 months post-fracture. Measurements of fracture displacement and post-treatment anatomic position were obtained from available radiographs (n = 101). Bivariate/stepwise multiple linear regression and ANOVA were used to explore factors that affect work loss.

RESULTS

The average number of weeks lost from work was 9.2 (SD = 9.7; range = 0-52, median = 8); although 21% of participants reported no lost time. Post-treatment or follow-up radiographic measures were not related to time lost from work. Self-reported disability and occupational demands were the strongest predictors of time lost. Models with self-reported disability produced higher R2 than those with physical impairment (40% vs. 29%), although some independent effects of both were evident (R2 = 43%). Significant bivariate predictors like educational level and worker's compensation were excluded in multivariate models that included occupational demand.

CONCLUSIONS

Work loss following DRF is highly variable and cannot be accurately predicted solely on the basis of clinical variables. Patients who have high self-reported pain/disability and occupational demand at baseline are at risk of prolonged work loss.