Return-to-work after acetabular fractures: the impact of injury severity on the post-rehabilitation working capacity and workload

Objective: Acetabular fractures are among the most severe injuries in trauma surgery. In younger patients, they typically result from high-energy trauma and are often associated with polytrauma. Treatment complexity and rehabilitation outcomes are influenced by overall injury severity. This study aimed to evaluate return to work (RTW) after acetabular fracture in relation to the overall injury severity score (ISS). Design/subjects/patients: A retrospective study included 22 patients treated for acetabular fractures at a Level I Trauma Centre spanning a period from January 2009 – December 2020. Methods: Patients completed a questionnaire assessing work-related factors and workload before (PRE) and after (POST) trauma (median [MD] = 126.4 ± 46.4 months POST). Based on ISS, patients were categorized as < 16 = “no polytrauma” (n = 8) and ≥ 16 = “polytrauma” (n = 14). Results: The RTW rate was 75% in both groups. However, descriptively the median workload reduction was greater in the “polytrauma” group (–50%) compared to the “no polytrauma” group (–33.3%). A shift toward sedentary work was seen in both groups, more prominently in the “polytrauma” subgroup (+40%) compared to the “no polytrauma” group (+11.4%). Conclusion: Possible workload was reduced after acetabular fracture. Despite similar RTW rates, polytrauma patients descriptively returned to less physically demanding work. Thus, ISS significantly predicts the outcome of the rehabilitations process after acetabular fractures.