Health related quality of life and return to work after minor extremity injuries: A longitudinal study comparing upper versus lower extremity injuries

Abstract

Purpose To investigate the impact on health related quality of life (HRQL) during the first year after minor extremity injury and to determine whether there is a difference in recovery patterns and return to work between upper extremity injuries (UEI) and lower extremity injuries (LEI). Method A total of 181 adults’ age 18 years or older randomly selected from patients admitted to an emergency department with minor injuries were studied. HRQL was measured using the Functional Status Questionnaire (FSQ) at 1–2 weeks, 3, 6, and 12-months post-injury. Pre-injury FSQ scores were measured retrospectively at admission. A quasi-least square (QLS) model was constructed to examine differences of FSQ scores at each measuring point for UEI and LEI. Results Fractures of the knee/lower leg (25%) were the most frequently injured body area. Slips or falls (57%) and traffic-related events (22%) were the most common injury causes. The mean ISS was 4.2 (SD 0.86). Both groups had significant declines in the FSQ scores physical and social functioning at 1–2 weeks after injury. Patients with UEI made larger improvements in the first 3 months post-injury versus patients with LEI whose improvements extended over the first 6 months. None of the groups reached the pre-injury FSQ scores during the first post-injury year except in the subscale work performance where UEI exceeded the pre-injury scores. At 12 months post-injury, significant lower FSQ scores remained in the LEI group compared to the UEI group in intermediate activities of daily living (p=0.036, d 0.4) and work performance (p=0.004, d 0.7). The return to work at 3 months and 12 months were 76% and 88% for UEI and 58% and 77% for LEI. No significant differences were found between groups in the FSQ scale mental health and social interaction. Conclusions LEI had the highest impact on HRQL and return to work during the first year which exceeded the consequences of UEI. These findings contribute to the information about the consequences of injury in order to give sufficient prognostic information to patients and different stakeholders. Future investigations should aim to investigate specific minor extremity injuries and identify factors that facilitate recovery and return to work.

Regulation of heterotopic ossification by monocytes in a mouse model of aberrant wound healing

“…rauma remains the number one cause of years of lost life and extremities are the most commonly injured anatomic sites 1,2 . After extremity trauma, an inflammatory response is mounted at the site of injury that promotes wound healing and regeneration of involved musculoskeletal tissues.…”

20-year trends of distal femoral, patellar, and proximal tibial fractures: a Danish nationwide cohort study of 60,823 patients

“…Knee fractures include fractures in the distal femur, patella, and proximal tibia, with a reported incidence rate (IR) of approximately 9/10 5 per year in the United States (Lambers et al 2012). Knee fractures vary in type and complexity and often result in lower function, work performance, and healthrelated quality of life (Van Dreumel et al 2015, Sluys et al 2016. Previous studies are limited to small sample sizes, lower extremity fractures, tibial plateau fractures, patellar fractures, or proximal tibia fractures (Court-Brown and Caesar 2006, Scholes et al 2014, Elsoe et al 2015, Larsen et al 2016, Wennergren et al 2018.…”

Perioperative pain management and chronic postsurgical pain after elective foot and ankle surgery: a scoping review

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