Evidence for return to work following complex orthopaedic injury - a scoping review.
Andreas Conte, Ellisiv Clarke, Aswinkumar Vasireddy
PMID 40255139WHAT IT FOUND
Return to work after complex orthopaedic injury has limited, inconsistent evidence.
Studies mostly examined open tibia fractures, not upper limb fractures, and predictors varied by injury type and time after injury. No consistent predictors emerged.
Key findings
01Only 11 studies met criteria for return to work, complex orthopaedic injury, and prognostic factors.
02The evidence base is limited and contains no meta-analysis, systematic review, or randomised controlled trial on this topic.
03Six studies examined open fractures, five focused on the tibia, and no studies examined prognostic factors for return to work after other open long bone fractures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 11 studies were included, and six had fewer than 100 subjects. The review did not assess risk of bias or the quality of the included studies. Follow-up periods and return-to-work reporting varied, so rates and predictors cannot be compared directly. The evidence is skewed to open tibial fractures, so it may not apply to upper limb fractures, pelvic fractures, multiple fractures or polytrauma. Mental health and workplace modifications were rarely tested in the included studies.
Declared interests
The authors reported no financial support for the research, authorship, or publication, and declared no potential conflicts of interest.
The easy way to misread this
Do not treat the reported predictors as proven causes of return-to-work failure. The review found inconsistent associations from heterogeneous observational studies, and it did not assess study quality or test interventions.