This study aims to describe the medical, social, and organizational determinants of returning to work after an osteoarticular injury, particularly limb fractures. Using observational data, the study will evaluate the modalities of returning to work within 12 months of the injury and analyze the factors influencing professional reintegration, including the severity of the injury, functional recovery, pain, professional characteristics, workplace accommodations, and administrative support measures such as recognition of disabled worker status. The study will also explore the point at which the issue of returning to work is first raised with the patient during hospitalization, a period during which professional reintegration is often insufficiently anticipated. By identifying current practices and breaking points, this study aims to improve understanding of the pathways to returning to work in the context of the healthcare system and the world of work in France.
Osteoarticular trauma, particularly limb fractures, is a major public health problem and frequently affects young people of working age. These injuries often result in prolonged interruption of professional activity and significant socioeconomic consequences. Returning to work is a key step in the rehabilitation process after trauma, but it is influenced by a wide range of medical, social, and organizational factors. Medical determinants include the severity of the injuries, functional limitations, pain, and long-term sequelae. In addition, professional and social factors such as the type of job, employer support, the possibility of workplace accommodations, and administrative procedures related to disability recognition can strongly influence the terms of return to work. Beyond clinical recovery, the organization of care pathways and coordination with occupational health services also play a decisive role in professional reintegration. This observational study aims to describe the pathways to return to work after osteoarticular trauma in the French context. It will assess the rate of return to work within 12 months of the trauma, as well as the time taken to resume professional activity. It will also analyze the medical, social, and professional factors associated with returning to work, including workplace accommodations and the implementation of administrative measures related to disability. The study will further explore the point at which the issue of return to work is first raised with patients during hospitalization. This period is a critical phase during which professional reintegration is often insufficiently anticipated. By identifying current practices and the timing of these discussions, the study aims to better characterize existing gaps in the early anticipation of professional return. By providing descriptive data on the determinants of return to work after osteoarticular trauma, this study aims to improve understanding of professional reintegration pathways and guide the development of future strategies that promote earlier anticipation and enhanced coordination of return to work within healthcare systems and the world of work.
Study Type
OBSERVATIONAL
Enrollment
200
Hôpitaux Paris Est Val-de-Marne - Service de rééducation orthopédique et traumatologie
Saint-Maurice, France
RECRUITINGReturn-to-work rate within 12 months after osteoarticular trauma
Assess the professional impact of osteoarticular trauma by measuring the rate of return to work within 12 months of the trauma.
Time frame: Up to 12 months after trauma
Time to return to work after osteoarticular trauma
Duration between the date of osteoarticular trauma and the date of return to work, expressed in days
Time frame: From inclusion to return to work (up to 12 months)
Workplace accommodations implemented after trauma
Implementation of workplace accommodations following osteoarticular trauma, including job adjustments, modified duties, or adapted working conditions
Time frame: Within 12 months after trauma, as reported at study inclusion
Recognition of disability status (RQTH)
Implementation of disability recognition status (Reconnaissance de la Qualité de Travailleur Handicapé, RQTH), a French administrative measure allowing access to workplace accommodations and vocational support.
Time frame: Within 12 months after trauma, as reported at study inclusion
Time to return to work and predictors (hazard ratios)
Time from inclusion to return to work will be measured in months. Time-to-event analysis will be performed using Kaplan-Meier survival curves. Medical, social, and occupational variables will be evaluated as predictors of time to return to work using Cox proportional hazards regression models. Results will be expressed as hazard ratios (HR) with 95% confidence intervals.
Time frame: Up to 12 months after trauma
Timing of return-to-work discussion during hospitalization
Time (in days) from hospital admission to the first discussion regarding return to work with the patient will be recorded during the hospitalization period.
Time frame: From hospital admission to hospital discharge (up to 30 days).
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