Socioeconomic impact of upper and lower extremity fractures among temporary migrant workers: A prospective...

Temporary migrant workers may be particularly vulnerable to financial and occupational consequences after fracture. This study evaluated longitudinal income changes and socioeconomic outcomes following appendicular fractures in this population.

This prospective cohort study included temporary migrant workers in Kuwait aged 18-65 years presenting with appendicular fractures between January 2023 and January 2025. Pre-injury income and income at 1, 3, 6 and 12 months were recorded and expressed as a percentage of individual baseline income. Unadjusted and exploratory multivariable analyses examined complete income loss at 12 months.

Of 601 patients assessed, 430 were included. Complete income loss affected 19.1% at 1 month, peaked at 35.1% at 3 months and persisted in 23.3% at 12 months. Mean income retained at 12 months was 65.8% of baseline: 55.5% in physically demanding labour versus 80.1% in professional roles. By 12 months, 77.0% had returned to work, but 58.0% of returners earned less than before injury. Self-employment (adjusted OR 3.02; 95% CI 1.57-5.82) and multiple fractures (2.21; 1.25-3.92) remained associated with complete income loss after adjustment; the occupational association was attenuated.

Appendicular fractures were followed by persistent socioeconomic disruption, with greater observed income deficits among physically demanding and self-employed workers and those with more extensive injuries. Returners often remained below baseline income at 12 months. Recovery assessment should include income and occupational stability.