title: Influence of socioprofessional category on the duration of sick leave after hallux surgery: a prospective study of 102 cases.
abstract: BACKGROUND
  Surgery of the forefoot including the hallux involves procedures on one bone or more. Usually bone union occurs within 45 days after surgery. During convalescence, the patient can gradually return to his/her activities. The duration of sick leave (SL) can be used to evaluate the influence of convalescence on professional life. The goal of this study was to evaluate the influence of the socioprofessional category (SPC) on the duration of SL after surgery of the forefoot including the hallux.
  
  
  METHODS
  This was a single center, single surgeon prospective cohort study performed between January 2012 and March 2013. It included working patients over 18 who underwent hallux surgery associated or not with surgery of the lateral rays. A standardized questionnaire was filled out during the postoperative day 45 consultation to determine factors that could influence the duration of sick leave. Regression models (Cox model) were used to indentify variables associated with the duration of sick leave.
  
  
  RESULTS
  Among the operated patients, 102 were included and divided into 5 SPC. SL lasted a mean 45 days (from 8 to 90 days). The only predictive factors for the duration of SL on multivariate analysis using SPC 2 as a reference were SPC and the VAS (Visual Analogue Scale). The mean duration of SL was 15 days for SPC 2, 35 days for SPC 3, 47 days for SPC 4, 50 days for SPC 5 and 67 days for SPC 6.
  
  
  CONCLUSIONS
  The distribution of SPC was comparable to that of the working population in the Île de France. The SPC appears to be a predictive factor for the duration of SL after hallux surgery. Severe pain seems to increase the duration of SL. Surgeons and patients should be informed accordingly.
  
  
  METHODS
  Level IV.
authors.affiliation: Groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France. Electronic address: wgraff@hopital-dcss.org.
authors.forename: W
authors.initials: W
authors.lastname: Graff
authors.affiliation: Inserm U1153, université Paris-Descartes, groupe hospitalier Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France. Electronic address: david.biau@cch.aphp.fr.
authors.forename: D
authors.initials: D
authors.lastname: Biau
authors.affiliation: Groupe hospitalier Diaconesses Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France. Electronic address: quentinmanach@hotmail.fr.
authors.forename: Q
authors.initials: Q
authors.lastname: Manach
mesh_terms: D003289:Convalescence; D005602:France; D006214:Hallux / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009790:Occupations / Q000706:statistics & numerical data*; D010147:Pain Measurement; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Hallux; Sick leave; Socioprofessional category