Return to work following traumatic hip dislocation: a prognostic outcome study

BACKGROUND: Traumatic hip dislocations are associated with high morbidity and overall limitations of daily living activities. Residual disability inhibits returning to work after severe injuries and minimizes financial independence and social involvement, which are both related to well-being and good health. The aim of this study was to analyze epidemiological and socioeconomic status following traumatic hip dislocations to identify predictors for return to work.

PATIENTS AND METHODS: Patients with traumatic hip dislocations from three level one trauma centers from 2009 to 2021 were followed up in terms of epidemiological data, return to work, change of work, and predictors of socioeconomic outcome. Inclusion criteria were age ≥ 18 years, employed patients, and a minimum follow-up of ≥ 2 years. Patients with incomplete or missing medical records, including radiological imaging and retired patients, were excluded. 107 patients met the inclusion criteria and 67 (63%) patients were available for follow-up.

RESULTS: A total of 81 male and 26 female patients with a mean age of 41.82 years (SD ± 15.65) were finally evaluated. A work-related accident was found in 28 patients (26%). Demographic data and treatment course did not differ significantly between the work-related and non-work-related accidents. Sixty-seven (63%) patients (51 male and 16 female) with a mean age of 42 years (SD ± 15.79) were included in the follow-up. Eighteen patients (27%) had not returned to their previous job and 12 patients (18%) had reduced income. Higher age and Body Mass Index (BMI) were significantly associated with a lower return rate to the pre-accident job (p < 0.05). Furthermore, lower Tegner Activity Scale, pain score, and modified Harris Hip Score were also significantly associated with lower return to work rate (p < 0.001) and reduced income.

CONCLUSION: Traumatic hip dislocations are associated with high rates of work-related injury and unsatisfactory low rates of return to previous work. Younger age, lower BMI, higher Patient reported outcome measures and lower pain levels may predict a successful return to previous job and a reduced risk of reduction in earning capacity. Understanding the predictive factors is crucial to identify patients at risk of not returning to work and to develop strategies that may help improve their chances of successfully returning to their previous employment.