Presenteeism and Absenteeism Before and After Carpal Tunnel Release or Open Reduction and Internal Fixation for Distal Radius Fracture.

PURPOSE

The use of a person's hands is crucial to their ability to succeed at work. Hand pathologies can impact work success by increasing absenteeism (ie, not being able to go to work) and presenteeism (ie, being able to work but in a reduced capacity). In this study, we quantified employed patients' presenteeism and absenteeism following carpal tunnel release or surgical fixation of a distal radius fracture (DRF).

METHODS

In this prospective cohort study, 91 patients (carpal tunnel syndrome [CTS]: n = 62; DRF: n = 29) from June 2022 to December 2023 were included. Baseline patient characteristics and patient-reported outcome measures (PROMs) were collected. Presenteeism and absenteeism were calculated using the World Health Organization's Health and Work Performance Questionnaire. Questionnaires were sought before surgery and at 3 and 6 months after surgery. Clinical improvement was determined using minimal clinically important difference (MCID) cutoff range estimates. The employee value of lost work was calculated as a percentage of the average patient in each group before surgery and at 6 months after surgery.

RESULTS

The average change in PROMs scores from before to after surgery at 6 months surpassed the low-end MCID estimates for all functional and pain-related PROMs. For patients undergoing surgery for CTS and DRF, retained employee value rose from 85.6% to 130.2% (ie, worked more than expected) and 52.7% to 56.9%, respectively.

CONCLUSIONS

Patients undergoing surgery for CTS or DRF have clinically appreciable improvement in functional and pain symptoms by 6 months after surgery. However, by 6 months after surgery, carpal tunnel release results in greater than complete employee value recovery, compared with surgical fixation of DRFs in which greater than 40% of the employee value remains lost after surgery. These findings can assist with preoperative expectation setting.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.