Returning to work following multiple fractures injuries: a case study of a dental specialist.

• Main Authors: Abu Hassan, Salmah Anim, Alias, Nurul 'Izzah
• Format: Article
• Language: English
• Published: Hospital Raja Permaisuri Bainun 2022
• Subjects: RZ Other systems of medicine
• Online Access: http://irep.iium.edu.my/99580/1/99580_Returning%20to%20work%20following%20multiple%20fractures.pdf; http://irep.iium.edu.my/99580/; https://myjms.mohe.gov.my/index.php/pmj/article/view/19126/10147

INTRODUCTION Work performance is one of the most relevant functional outcome measures of injuries and a key element in rehabilitation of adult patients. A client-centred approach is compulsory in designing a Return to Work (RTW) program to achieve the highest potential of work productivity hence improving total Quality of Life (QoL). OBJECTIVES This case emphasizes a holistic work rehabilitation process in ensuring a successful RTW program for a dental specialist following multiple fractures involving bilateral forearm and right femur. CASE SUMAMRY A 33-year-old gentlemen working as a clinical specialist and academician, suffered multiple fractures of bilateral forearm and right femur following a motor vehicle accident. Post-trauma, open reduction internal fixation (ORIF) was done at all affected fractures. At 4-months follow-up revision from titanium elastic nails to plating of the right ulnar bone. Client was later assigned to RTW program for work rehabilitation where job analysis, Functional Capacity Evaluation (FCE), work conditioning and work hardening was conducted 6-months post trauma. In order to prevent an extended medical leave, a well- structured RTW process was laid out as a guideline in order to ensure a successful outcome. RESULTS Work conditioning was done with conventional techniques complemented by isometric maximum strength test. Improvement by 15.7% for right pinch strength and 22.7% for right grip strength was noted prior to RTW. After 3 months, progression in writing and typing speed was also noted. Job modification with exclusion of clinical tasks was suggested as client still had limitations and the requirements of physical functional elements of work demands are still not met upon returning to working after seven months on medical leave. This approach helped client to cope with the limitations in returning to a high stress career and allowing a transition period. Findings highlight that injured workers who are offered modified work are more likely to return to work compared to those who are not. CONCLUSION The client managed to return to his previous occupation with the same employer and job modifications after attending outpatient rehabilitation sessions. In conclusion, tailored RTW intervention and collaboration among multidisciplinary teams could improve productivity and reduce the risk of prolonged work disability.