Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands; Hand and Wrist Center, Xpert Clinic, Amsterdam, the Netherlands.
Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands; Hand and Wrist Center, Xpert Clinic, Amsterdam, the Netherlands.
J Hand Surg Am. 2022 Aug;47(8):794.e1-794.e11. doi: 10.1016/j.jhsa.2021.07.022. Epub 2021 Sep 10.
The primary aim of this study was to analyze the median time until patients performed their usual work following an ulnar shortening osteotomy (USO). The secondary aim was to identify factors influencing the median time until return to their usual work.
We used a retrospective cohort of patients with ongoing data collection from our institution in the Netherlands. Patients with paid employment who underwent USO were invited to complete a return-to-work questionnaire at 6 weeks, 3 months, 6 months, and 12 months after surgery. The probability of and median time until return to usual work were assessed using an inverted Kaplan-Meier analysis. Factors influencing the return to usual work were evaluated using multivariable Cox proportional hazard regression.
In total, 111 patients who underwent USO were included, with a mean age of 46 years. The probability of returning to usual work in the first year was 92%, and the median time was 12 weeks. The type of work was independently associated with a return to work, with median times of 8, 12, and 14 weeks for light, moderate, and heavy physical work, respectively. We did not find differences in return to usual work based on age, sex, duration of complaints until surgery, treatment side, smoking status, the preoperative Patient-Rated Wrist Evaluation score, or whether the osteotomy was performed freehand or with an external cutting device.
Half of the patients that underwent USO fully performed their usual work by 12 weeks following surgery. We found that 92% of the patients performed their usual work within 1 year after surgery. We found a large variation in the time until a return to work based on the type of work. Surgeons can use this data to inform patients on the rehabilitation phase after USO.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
本研究的主要目的是分析尺骨缩短截骨(USO)后患者恢复日常工作的中位时间。次要目的是确定影响恢复日常工作的中位时间的因素。
我们使用了来自荷兰机构的持续数据收集的回顾性队列研究。有带薪就业的患者在手术后 6 周、3 个月、6 个月和 12 个月被邀请完成一份重返工作问卷。使用倒转 Kaplan-Meier 分析评估恢复日常工作的概率和中位时间。使用多变量 Cox 比例风险回归评估影响恢复日常工作的因素。
共纳入 111 例行 USO 的患者,平均年龄为 46 岁。第一年恢复日常工作的概率为 92%,中位时间为 12 周。工作类型与恢复工作独立相关,轻、中、重体力劳动的中位时间分别为 8、12 和 14 周。我们没有发现基于年龄、性别、手术前抱怨持续时间、治疗侧、吸烟状况、术前患者自评腕关节评估评分或截骨术是徒手还是使用外部切割装置进行,对恢复日常工作有差异。
接受 USO 的患者中有一半在手术后 12 周内完全恢复了日常工作。我们发现 92%的患者在手术后 1 年内恢复了日常工作。我们发现根据工作类型,恢复工作的时间存在很大差异。外科医生可以使用这些数据来告知 USO 后康复阶段的患者。
研究类型/证据水平:预后 IV 类。