Predictors of Time Lost from Work Following a Distal Radius Fracture

Study Design: Prospective Cohort. Objective: to describe time lost from work following a distal radius fracture. Method: A cohort of 227 workers with distal radius fracture was enrolled at a baseline visit to the hand clinic where injury, patient characteristics, and occupational demand were recorded. Patients were followed up at 2, 3, 6, and 12 months and self-reported time lost from work, disability (PRWE, DASH), and health (SF-36). Impairments of grip strength, wrist motion and dexterity were measured at 2 and 3 months post-fracture. Measurements of fracture displacement and post-treatment anatomic position were obtained from available radiographs (n = 101). Bivariate/stepwise multiple linear regression and ANOVA were used to explore factors that affect work loss. Results: The average number of weeks lost from work was 9.2 (SD = 9.7; range = 0–52, median = 8); although 21% of participants reported no lost time. Post-treatment or follow-up radiographic measures were not related to time lost from work. Self-reported disability and occupational demands were the strongest predictors of time lost. Models with self-reported disability produced higher R2 than those with physical impairment (40% vs. 29%), although some independent effects of both were evident (R2 = 43%). Significant bivariate predictors like educational level and worker’s compensation were excluded in multivariate models that included occupational demand. Conclusions: Work loss following DRF is highly variable and cannot be accurately predicted solely on the basis of clinical variables. Patients who have high self-reported pain/disability and occupational demand at baseline are at risk of prolonged work loss.