Return to Work after Upper or Lower Extremity Long Bone Fractures: Social Factors in a Japanese Multicenter Cohort...

Area of Science:

• Orthopedics
• Occupational Health
• Socioeconomics

Background:

• Fractures significantly hinder employment, impacting individuals and the economy.
• Limited evidence exists in Japan on social determinants, such as nonregular employment, affecting return to work (RTW) post-injury.

Purpose of the Study:

• To investigate the association between social factors and RTW following injury in Japan.
• To identify specific social determinants that influence the timing and rate of RTW after surgical fracture repair.

Main Methods:

• Multicenter cohort study (2015-2018) including 674 surgically treated long bone fracture patients (aged 18-65).
• Primary outcome: RTW rate at 6 months, 1 year, and 2 years post-injury.
• Logistic regression and Cox proportional hazards models adjusted for patient and fracture factors.

Main Results:

• Overall RTW rates were 77.9% at 6 months and 89.3% within 2 years.
• Physical labor, open fractures, and chronic pain correlated with RTW at both 6 months and 2 years.
• Nonregular employment and workers' compensation insurance were associated with 6-month RTW only; social factors impacted early RTW but not long-term recovery.

Conclusions:

• Approximately 10% of patients did not return to work within two years.
• Social factors, particularly nonregular employment, pose a risk for delayed early RTW.
• Findings suggest a need for policy-level interventions to support RTW for injured workers.