Occupational Medicine Advance Access originally published online on November 11, 2005
Occupational Medicine 2006 56(1):46-50; doi:10.1093/occmed/kqi194
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Time to return to work and surgeons' recommendations after carpal tunnel release
1 Department of Occupational Therapy, Tel Aviv University, PO Box 39040, Ramat Aviv, 69978 Tel Aviv, Israel
2 Formerly at: Department of Occupational Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
3 Department of Epidemiology and Preventive Medicine, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
Background Time to return to work after carpal tunnel release is extremely variable suggesting that only a small proportion of total sick-leave is for medical reasons.
Aims To determine factors predicting a delayed return to work.
Methods Fifty consecutive employed patients undergoing carpal tunnel surgery were tested pre-operatively, and then at 1 month post-operatively using both questionnaires and objective testing. Further follow-up by telephone was carried out every 2 weeks up until 90 days.
Results Forty-nine of the 50 workers had returned to work by 3 months. Time to return to work was extremely variable ranging from 1 to 88 days in those who returned to work. Post-operative recommendations by the surgeon also varied widely from 1 to 36 days. The surgeons' recommendations were the strongest predictors of delayed return to work [odds ratio 30.5; 95% confidence interval (CI), 3.2288], with physical work (odds ratio 27.7; 95% CI, 1.5507) and lack of self-rated health (odds ratio 5.0; 95% CI, 1.11100) adding significantly to the logistic regression model, which was highly predictive (area under the receiveroperator curve of 88%). Patient symptoms and objective findings of disability did not add significantly to a logistic regression model either predicting return to work or the surgeon's recommendations.
Conclusions Our study suggests that workers will return to work in less than 3 weeks if recommended by the surgeon. A randomized controlled trial is warranted to determine if a higher proportion of workers returning in less than 3 weeks can be obtained by standardizing surgeons' recommendations.
Keywords Absenteeism; carpal tunnel release; occupational; surgeons' recommendations
Correspondence to: Navah Ratzon, Department of Occupational Therapy, Tel Aviv University, PO Box 39040, Ramat Aviv, 69978 Tel Aviv, Israel. Tel: +972-3-6405443; fax: +972-3-6409933; e-mail: navah{at}post.tau.ac.il
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