Return to Usual Work Following an Ulnar Shortening Osteotomy: A Sample of 111 Patients

Abstract

§k on behalf of the Hand-Wrist Study Group, Brigitte Van der Heijden, PhD, MD*{ Purpose The primary aim of this study was to analyze the median time until patients performed their usual work following an ulnar shortening osteotomy (USO). The secondary aim was to identify factors influencing the median time until return to their usual work.Methods We used a retrospective cohort of patients with ongoing data collection from our institution in the Netherlands. Patients with paid employment who underwent USO were invited to complete a return-to-work questionnaire at 6 weeks, 3 months, 6 months, and 12 months after surgery. The probability of and median time until return to usual work were assessed using an inverted Kaplan-Meier analysis. Factors influencing the return to usual work were evaluated using multivariable Cox proportional hazard regression.Results In total, 111 patients who underwent USO were included, with a mean age of 46 years. The probability of returning to usual work in the first year was 92%, and the median time was 12 weeks. The type of work was independently associated with a return to work, with median times of 8, 12, and 14 weeks for light, moderate, and heavy physical work, respectively. We did not find differences in return to usual work based on age, sex, duration of complaints until surgery, treatment side, smoking status, the preoperative Patient-Rated Wrist Evaluation score, or whether the osteotomy was performed freehand or with an external cutting device.Conclusions Half of the patients that underwent USO fully performed their usual work by 12 weeks following surgery. We found that 92% of the patients performed their usual work within 1 year after surgery. We found a large variation in the time until a return to work based on the type of work. Surgeons can use this data to inform patients on the rehabilitation phase after USO.

Outcomes of ulna shortening osteotomy: a cohort analysis of 106 patients

“…While all USOs were performed at the level of the diaphysis using an oblique cut, there was variation in the manner of the osteotomy (freehand versus specific USO devices) and the type and position of the fixation plate, which may have influenced the outcomes during follow-up. Although previous research did not find a difference in pain relief or return to work between freehand USO and specific USO devices [ 32 , 33 ]. Fourth, some patients underwent concomitant surgery during the USO, which could have induced some co-treatment bias.…”

Routinely-Collected Outcomes of Proximal Row Carpectomy

“…However, the time until RTW is similar to that for other major wrist surgeries in our sample, such as open triangular fibrocartilage complex repair and ulna shortening osteotomy. 18,26 Previous studies have shown that grip strength of 75%e91% of the contralateral side can be expected and a ROM arc of 72 e76 . 23,24 The present study enhances our knowledge by showing that although there is a reduction at 3 months, patients can be reassured that by 12 months, they will have regained almost 100% of their preoperative grip strength, although the operated side remained impaired compared with the unoperated hand (81% of unoperated hand).…”

“…Details on the RTW questionnaire and definitions have been described previously. 18 Patients completed their level of satisfaction with treatment results by email on a validated 5-point Likert scale. 19 A hand therapist measured the active wrist ROM and grip strength during consultation before, and at 3 and 12 months after surgery.…”

Type of Work and Preoperative Ability to Perform Work Affect Return to Usual Work Following Proximal Interphalangeal Joint Arthroplasty for Osteoarthritis

“…30 We selected age, sex, occupational intensity, dominance, the duration of symptoms (in months), and MHQ scores at baseline as possible influencing factors of the RTW based on previously published literature. [20][21][22] Besides, the authors agreed upon adding hand comorbidity, diagnosis, and implant type as possible influencing factors specifically for patients following PIP joint arthroplasty. We evaluated the median times until RTW of all factor subgroups, and in the case of continuous variables, we categorized based on the median value.…”

“…Return to work studies have been performed for other hand disorders, and injuries and several prognostic factors, such as sex, type of work, and the amount of postoperative pain, for RTW were found. [18][19][20][21] For instance, among patients undergoing surgical treatment for trapeziometacarpal osteoarthritis, the physical occupational intensity, surgery on the dominant hand, and better Michigan Hand Outcomes Questionnaire (MHQ) work score and hand function score of the opposite hand preoperatively led to a shorter time until patients returned to work. 22 Which factors are of importance for patients' RTW following PIP joint arthroplasty for osteoarthritis is unknown.…”