title: Return-to-Work Following Open Reduction and Internal Fixation of Proximal Humerus Fractures.
abstract: OBJECTIVE
  Shoulder disorders have an important impact on a patient's capacity to work. We investigated whether there is a relationship between subjective or objective outcome measures and the ability and time for returning to work (RTW) after a proximal humerus fracture (PHF).
  
  
  METHODS
  Retrospective single-centre study from March 2003 to June 2008.
  
  
  METHODS
  City hospital, trauma level one centre.
  
  
  METHODS
  All PHF stabilized with a PHILOS(®).
  
  
  METHODS
  Routine follow-up examinations (X-ray, Constant-Murley Score (CMS), Short-Form 36 (SF-36)) were performed prospectively after 1.5, 3, 6 and 12 months or until RTW. Primary interest was the comparison of the outcome scores with the time needed for RTW.
  
  
  RESULTS
  72 patients (52 years (22-64), 37 (51%) women) fulfilled the inclusion criteria. We distinguished "office-workers" (OW) (n = 49, 68%) from patients who worked at a physically demanding job (PW) (n = 23, 32%). Although time for RTW was fundamentally different (42 (OW) vs 118 days (PW), p<0.001), CMS (64.7 vs 64.1) and SF-36 (66.8 vs 69.9) at time of RTW were almost identical. At follow-up, CMS and SF-36 were always lower in the PW group.
  
  
  CONCLUSIONS
  Jobs which require higher physical demands were likely to influence and to delay RTW. This study identifies cut off values for CMS and SF-36 at which a patient feels capable or willing to RTW after PHF. These values show the importance and impact of a patient's occupation or demands on RTW. We were able to show, that besides age, sex and fracture, the type of occupation might alter the scores in postoperative outcomes.
authors.affiliation: Department of Orthopaedics, University Hospital Balgrist, Zurich, Forchstrasse 340, CH-8008 Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Dietrich
authors.affiliation: Department of Traumatology, City Hospital Triemli Zurich, Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Wasmer
authors.affiliation: Department of Traumatology, City Hospital Triemli Zurich, Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Platz
authors.affiliation: Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, Rorschacherstr. 95, CH-9007 St. Gallen, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Spross
keywords: CMS; SF-36; fracture; proximal humerus; return to work; workers compensation.