Article
Return to work following 28 elective procedures for hand and wrist conditions: a cohort analysis of 14,536 patients
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Authors
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Joris Sebastiaan Teunissen
- Radboud Universiteit Nijmegen, Nijmegen, Netherlands
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Brigitte van der Heijden
- Radboud Universiteit Nijmegen, Nijmegen, Netherlands
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Ruud W Selles
- Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
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Lisa Hoogendam
- Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
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Harm Slijper
- Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
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Mark van der Oest
- Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
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Steven ER Hovius
- Radboud Universiteit Nijmegen, Xpert Clinics, Nijmegen, Netherlands
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Reinier Feitz
- Radboud Universiteit Nijmegen, Erasmus Medical Centre Rotterdam, Nijmegen, Netherlands
| Published: | October 6, 2022 |
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Outline
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Objectives: What is the median time until return to usual work (RTW) after common elective surgical procedures for hand and wrist conditions?
Method: This study is based on data from a longitudinally maintained database of patients with hand and wrist conditions surgically treated in one of 26 outpatient clinics in the Netherlands between November 2013 and January 2022. All adult patients with paid employment were asked to complete a RTW questionnaire after surgery at multiple predefined time points. RTW was defined as performing the original work for at least 50% of the contractual hours. The median time until RTW was assessed using inverted Kaplan-Meier analyses. The associations between patient characteristics at baseline and RTW were evaluated using multivariable Cox proportional hazard regression.
Results and Conclusion: A total of 14,536 patients (median age: 53 (IQR 16); 62% female) who provided RTW data were analysed. There were large differences between the 28 unique surgical procedures evaluated, ranging from a median of 0,1 week for needle aponeurotomy to 12 weeks for ulna shortening osteotomy. The longest durations until RTW were found in ulna shortening osteotomy (12; [12–16]), proximal row carpectomy (median 12; 95%CI [10–14]), TFCC reinsertion (12; [12–14]), and surgical treatment for thumb base osteoarthritis (12; [12–13]) and instability (12; [10–12]). While adjusting for the type of procedure, patient characteristics associated with a longer duration until RTW were female sex (hazard ratio: 0.79; 95%CI [0.76–0.82]), and a heavier workload (light to moderate: 0.47; [0.44–0.48]) (light to heavy: 0.35; [0.33–0.37]). Higher age was associated with a shorter duration until RTW (per 10 years: 1.04; 95%CI [1.02–1.06]).
This study provides insights into the median time until return to work for 28 elective surgical procedures for hand and wrist conditions. We identified factors associated with the duration until RTW, which can be used for more individualised estimations. Surgeons can use this data to inform patients about their rehabilitation phase after surgery.
