Return to work after proximal humeral fractures: a single center study comparing conservative versus operative treatment.

Abstract

Background: Adequate treatment of proximal humeral fractures (PHF) is essential for restoring shoulder function and expediting return-to-work (RTW). This study aims to assess the impact of conservative and operative treatments on RTW and PHF recovery.

Objective & methods: In a retrospective case-control study, 858 patients (aged 18-68) treated for PHF between 2018 and 2021 were included. Questionnaires were sent to 342 operatively treated patients (Operative group (OG)) and 191 conservatively treated matched controls (Conservative group (CG)). Assessments covered RTW, functional outcomes (DASH, ASES), and quality of life (EQ-5D). A Kaplan-Meier analysis explored RTW in weeks.

Results: With a 61% response rate, 73 eligible participants (40 OG, 33 CG) contributed. Of respondents, 67.1% were female, and 60% were employed pre-trauma. Almost 70% of employed patients RTW, with no significant difference between groups (log rank, p=0.36). Among those returning to work, OG tended to resume 4 weeks later than CG (OG 10.5, IQR 22 vs. CG 6.00, IQR 8 weeks, p=0.07). DASH, ASES, and quality of life VAS scores showed no statistical difference between groups (p=0.542, p=0.257, p=0.530, respectively).

Conclusion: The RTW proportion did not differ between operatively and conservatively treated PHF patients, though the former tended to return 4 weeks later. Functional outcomes demonstrated no significant differences. Further adequately powered studies are necessary to establish a standardized aftercare protocol for PHF, enhancing patient care and minimizing work disability.