Disability and Pain are the Best Predictors of Sick Leave After a Distal Radius Fracture in Men.
Lisa Egund, Karin Önnby, Fiona Mcguigan and 1 others
PMID 32052265WHAT IT FOUND
Men with distal radius fracture who reported more disability and pain one week after injury were more likely to have longer sick leave.
Early symptoms tracked work loss more closely than fracture severity or treatment.
Key findings
01At one week after fracture, higher self-reported arm disability and pain were associated with longer sick leave (DASH score r_s = 0.38; DASH pain question r_s = 0.41).
02Men with prolonged sick leave had a DASH score 22 points higher at 1 week than men with short sick leave (p = 0.001).
03Conventional fracture factors such as treatment method and radiographic displacement showed weaker associations with sick leave than self-reported disability and pain.
STILL TO COME
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What it does not show
The cohort was small: 88 men participated, and only 7 were in the prolonged sick leave group. Only 88 of 244 eligible men agreed to participate, although age distribution did not differ between participants and non-participants. Sick leave was self-reported and not verified against administrative records. The sick leave question was added after the original osteoporosis study was designed, so work culture, social situation and sense of coherence were not measured. The study included Swedish men aged 18-65 in work or education, so it may not apply to women, older or retired men, or other health insurance systems. Treatment reflected the study period, with surgery mainly external fixation, which may differ from current practice. No objective arm function measures such as range of motion or grip strength were collected. This was an observational cohort, so associations do not show that treating pain or disability will shorten sick leave.
Declared interests
Funding was provided by Vetenskapsrådet, Greta och Johan Kocks stiftelser, Direktör Albert Påhlssons Stiftelse, Agda och Herman Järnhardts Stiftelse, Skånes universitetssjukhus, and Skåne County Council's Research and Development Foundation.
The easy way to misread this
Do not conclude that reducing early pain or disability will shorten sick leave. This was an observational cohort, not a treatment trial, and sick leave was self-reported.