Analysis of Factors Affecting Return to Work After Surgical Treatment in Patients with AO Type C Distal Humerus Fractures

Abstract

Background The purpose of this study is to evaluate the functional results of distal humerus fractures which were treated by open reduction and fixation with pre-contoured angular stable plates in young patients, and investigate whether the patients could return to their pre-injury work and patients' financial conditions while they were not working. Materials and MethodsThe data of 48 patients, ages between 18 and 55 years, working in a job and having AO/OTA type C distal humerus fracture were retrospectively evaluated. Mayo Elbow Performance Score (MEPS) was used to determine functional results. Postoperative radiographs were evaluated to determine the rate of union, degenerative changes, malunion and heterotopic ossification. Financial outcome form was constituted by the authors and the patients asked whether she/he could return to their pre-injury works after treatment finished and the financial status of the patients during the treatment and after the treatment. ResultsThe mean flexion-extension arc was 114° ± 12°(range 85°-135°) and the mean MEPS score was 85 ± 11(range 65-100). The average time to return to work was 6.5 ± 2.4 months (3-12 months). AO type C2 and C3 fractures and heterotopic ossification negatively affected the functional results and also adversely affected the patients' return to their pre-injury works. 38 (79%) patients returned to pre-injury work and 29 (76%) of them started to work at the same position before the fracture occured. Nine of 38 patients (24%) had to change their positions. Among the 48 patients, 10 patients (21%) could not return to the same work, 7 of them found light duty and 3 of them had not been to work. Conclusion Although the functional results of surgical treatment of intra-articular distal humerus fractures are good, at the end of the treatment, especially heavy workers may have difficulties in returning to their former works.

Clinical and Functional Outcomes of Anatomical Plating in Distal Humerus Fractures in Adults

“…According to a study by Kumbaraci et al [25], the maximum percentage of distal humerus fracture patients treated with pre-contoured anatomical plates had to change their profession from their preinjury work; however, in our study, only two (10%) patients had to change their profession.…”

Surgical Treatment of Radial Nerve Injuries Associated With Humeral Shaft Fracture—A Single Center Experience

“…The incidence increases with age and may be associated with significant in-patient mortality and health care utilization costs ( 2 , 5 – 7 ). In addition, the patients remain unable to return to work for a long period even after the surgery ( 8 , 9 ), which is a significant socioeconomic issue ( 10 ).…”

Combined Medial and Lateral Approach Versus Paratricipital Approach in Open Reduction and Internal Fixation for Type C Distal Humerus Fracture: A Randomized Controlled Study

“…Distal humerus fractures involve the supracondylar region and articular surface of distal humerus, which are relatively uncommon in adults and account for approximately 2%–6% of all humeral fractures and 30% of all elbow fractures 1–3 . These fractures frequently occur in a bimodal distribution: low‐energy trauma among the elderly and the patients with osteoporosis, high‐energy trauma in young patients 4 . The majority of these fractures were intra‐articular and required anatomic reduction of the articular surface and rigid fixation in order to tolerate earlier postoperative rehabilitation 4 .…”

“… 1 , 2 , 3 These fractures frequently occur in a bimodal distribution: low‐energy trauma among the elderly and the patients with osteoporosis, high‐energy trauma in young patients. 4 The majority of these fractures were intra‐articular and required anatomic reduction of the articular surface and rigid fixation in order to tolerate earlier postoperative rehabilitation. 4 Only patients who have entirely undisplaced fractures, those who suffer with severe comorbidity, and those unable to tolerate surgical anesthesia risks were candidates for nonoperative treatment of distal humerus fractures.…”

“… 4 The majority of these fractures were intra‐articular and required anatomic reduction of the articular surface and rigid fixation in order to tolerate earlier postoperative rehabilitation. 4 Only patients who have entirely undisplaced fractures, those who suffer with severe comorbidity, and those unable to tolerate surgical anesthesia risks were candidates for nonoperative treatment of distal humerus fractures. 3 Except for the circumstances listed above, all distal intra‐articular humerus fractures should be managed with surgical treatment to regain a painless, stable, and mobile elbow.…”