<< Back to the abstract archive
Back to Work: Factors Affecting Occupational Downtime after Digital Amputation
Elizabeth A. Moroni MD MHA, Justine S. Kim MD, Shawn J. Loder MD, Alexander M. Spiess MD
UPMC Plastic Surgery
2020-02-14
Presenter: Elizabeth Moroni
Affidavit:
This is original work from Elizabeth Moroni
Director Name: Vu T. Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Background: Rehabilitation of severe hand injuries is a prolonged process requiring extensive operative, clinical, and therapeutic resources. Digital amputations can severely limit a patient's ability to work and minimizing occupational downtime is central to many patients' rehabilitation. In this study we evaluated factors associated with prolonged occupational downtime after amputation.
Methods: We examined 113 patients with finger amputations between 2010-2019 and tracked them from initial intervention to terminal discharge from clinic. We assessed utilization of clinic, therapy, and operative resources. These were compared to injury and patient social, surgical, and medical demographic to identify trends in utilization.
Results: Our population averaged 0.93 operative interventions per trauma. Time from trauma to clinic was 7.0+/-5.8 days and patients were followed on average 192.5+/-207.9 days. 60 patients sought surgical clearance to return to work and were cleared 161.4+/-128.1 days from injury.
Injury to dominant hand, injuries to the thumb, >1 finger amputation, crush injuries, multiple operative interventions, and work-related injury were associated with greater delay in return to work. Revision amputation at time of initial triage was associated with more rapid return to work. Patients working in factory or farm-based jobs had a greater delay in return to work versus construction, carpentry, or non-manual labor.
Conclusions: Time off work was strongly influence by factors related to the initial injury pattern and patient demographics at time of injury. These data suggest the possibility of patient stratification to target rehabilitative and operative patients to those most likely to need additional assistance for return to work/function.
