Short-term Financial Outcomes of Pilon Fractures

Abstract 

Fractures of the distal tibia are potentially devastating injuries fraught with many complications and poor outcomes, including financial hardships. The purpose of this study was to examine the financial outcomes in the short term of pilon fractures. Sixty patients who sustained pilon fractures were prospectively assessed on financial criteria and injury characteristics. This included various scores and also introduced a financial data sheet and outcome form. Twenty-five patients met inclusion/exclusion criteria and were available for follow-up. The mean age was 46.3 ± 12.0 years (19–61 years), with a mean follow-up of 11.8 ± 4.8 months (6–20 months). Only 7 patients (29.2%) returned to work at latest follow-up. Seven of 19 patients (36.8%) reported selling possessions to meet financial obligations, and 8 of 19 patients (42.1%) used social assistance programs. All 4 white-collar workers returned to work whereas only 3 (14.3%) of 21 blue-collar workers had returned to work at last follow-up (P = .001). Five (62.5%) of 8 patients who had graduated from college returned to work, but only 2 (14.3%) of 14 patients who did not attend college returned to work (P = .01). Because there are no widely used measures of financial status change in the literature, we have introduced some in this article including preinjury financial preparedness and postinjury strategies to fulfill financial obligations. These may be useful in evaluating outcomes and counseling patients. In addition, we have again demonstrated that there is a significantly higher return to work outcome in white collar jobs and higher education.

Level of Clinical Evidence: 4

Keywords: pilon, distal tibia, outcome, education, lower extremity trauma