Abstract
BACKGROUND: Distal radius fracture (DRF) is the most common of fractures, accounting for 18% of all fractures. The ability to return to work is an important outcome for both society and the individual, but there is a large variation among patients in how much time off work is required. The choice of treatment is likely an important factor. METHODS: This study was a secondary analysis of an earlier published randomised clinical trial comparing volar locking plate fixation with combined dorsal and volar plate fixation of AO type C DRF. In the present study, we examined the the duration of sick leave among patients who were in the workforce at the time of fracture. RESULTS: There were 84 cases included in this analysis.Combined plating was associated with a significantly longer time to return to work following a type C DRF, in comparison to treatment with a volar locking plate. The crude difference was 0.67 months (p = 0.33; 95% CI: 0.85-1,26 months), and 0.65 months (p = 0.15; 95% CI: 0.13-1.17) when adjusting for differences in manual labour indicating a statistically significant difference time until return to work. CONCLUSIONS: Sick leave is an important contributor to total costs in patients with DRF, and more invasive treatments like combined plating are associated with longer sick leave. Our results indicate a longer time until return to work in the combined plating group, possibly due to more extensive soft tissue dissection. We recommend a restrictive use of combined plating. TRIAL REGISTRATION: The study was registered in the Swedish research database FoU in Sweden (registration number: 274674) on the 4th of August 2020.