Impact of Osteoporotic Fractures on Work: Data From a Fracture Liaisons Service (OPTIWORK)

New osteoporosis management programs have emerged in recent years, in order to improve the management of this pathology by linking the specialties concerned. Among them, La Filière Fracture (in Anglo-Saxon: Fractures Liaisons Services: FLS) of the Paris Saint-Joseph Hospital Group (GHPSJ), created in 2015, aims to follow up patients consulting the GHPSJ for an osteoporotic fracture of spinal location. , the upper end of the femur or the lower end of the radius.

Since the creation of the sector, 2,486 patients have been recruited; it was found that in 529 of these patients (or 21.3%), the osteoporotic fracture occurred at an age of less than 65 years.

The impact on the work of an osteoporotic fracture has been little studied in the literature: a study focused specifically on fractures of the upper extremity of the femur, and found, in 291 patients under 65 years recruited between 2009 and 2013, a 65% return to work rate at 12 months, or around a third of patients who have not returned to professional activity at one year. A study published in 2016 assessed return to work delay and factors associated with return to work in 275 patients with fragility fractures in Canada; 88% had returned to work with an average absenteeism period of 20.5 days. The average duration of presenteeism (presence at work but with reduced productivity due to the fracture) was 2.9 hours in 4 weeks. Another Japanese study found a risk ratio of 4 (p <0.001) to greater absenteeism in patients with several osteoporotic fractures, with no difference found in terms of productivity at work compared to patients with a history of a single fracture or without history of osteoporotic fracture. The female sex, the need for surgical management, the existence of work with the need to carry heavy loads were associated with a prolonged return to work time.

The objective here is to assess the occupational impact of osteoporotic fractures occurring in active patients under 65 years of age, and to look for factors predicting a return to work within 3 months after the fracture.