南非下肢长骨骨折髓内钉固定术后重返工作岗位的情况。

Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

School of Medicine, University of Liverpool, Liverpool, United Kingdom.

J Bone Joint Surg Am. 2023 Apr 5;105(7):518-526. doi: 10.2106/JBJS.22.00478. Epub 2023 Feb 10.

BACKGROUND

Injuries are one of the leading causes of global death and disability and commonly have substantial economic implications. The economic impact of injuries is particularly pronounced in low- and middle-income countries, where 90% of injuries occur. In this study, we aimed to assess return-to-work rates of individuals who sustained a lower-limb long-bone fracture in South Africa and to identify factors that influence the ability to return to employment.

METHODS

This prospective cohort study was conducted across 2 tertiary trauma centers in Cape Town, South Africa. Adults who received intramedullary nail fixation for a lower-limb fracture between September 2017 and December 2018 were recruited and followed for 18 months postoperatively. The participants' return to employment was assessed at 6 and 18 months post-injury. Multivariate logistic regression was used to identify factors that influence post-injury employment.

RESULTS

Of the 194 participants enrolled, 192 completed follow-up. The study population had a median age of 33.0 years, and most of the participants (76.6%) were male. Seventy-five percent of the participants were employed before their injury. At 6 and 18 months post-injury, 34.4% and 56.3% of participants, respectively, were employed. Of those employed pre-injury, 70.1% had returned to work at 18 months. Multivariate regression identified increasing age, unemployment prior to injury, and working in the informal employment sector as factors that impede an individual's likelihood of working 18 months post-injury. For those in employment prior to injury, increasing age was the only factor found to impede the likelihood of returning to work following an injury.

CONCLUSIONS

This study highlights the profound effect that lower-limb long-bone fractures may have on an individual's ability to return to work in South Africa, with the potential to cause substantial economic impact on an individual's livelihood and that of their dependents.

LEVEL OF EVIDENCE

Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

背景

损伤是导致全球死亡和残疾的主要原因之一，通常会产生重大的经济影响。损伤的经济影响在低收入和中等收入国家尤为明显，这些国家 90%的损伤发生于此。在这项研究中，我们旨在评估在南非发生下肢长骨骨折的个体的复工率，并确定影响就业能力的因素。

方法

这是一项在南非开普敦的 2 家三级创伤中心进行的前瞻性队列研究。2017 年 9 月至 2018 年 12 月期间接受髓内钉固定治疗下肢骨折的成年人被招募并在术后 18 个月进行随访。在受伤后 6 个月和 18 个月评估参与者的就业恢复情况。多变量逻辑回归用于确定影响受伤后就业的因素。

结果

在 194 名入组的参与者中，有 192 名完成了随访。研究人群的中位年龄为 33.0 岁，大多数参与者（76.6%）为男性。75%的参与者在受伤前有工作。受伤后 6 个月和 18 个月，分别有 34.4%和 56.3%的参与者就业。在受伤前有工作的人中，70.1%在 18 个月时已恢复工作。多变量回归确定年龄增长、受伤前失业以及在非正规就业部门工作是阻碍个体在受伤后 18 个月工作的可能性的因素。对于受伤前有工作的人，年龄增长是阻碍受伤后重返工作岗位的唯一因素。