Epidemiology and socioeconomic consequences of work-related pelvic and acetabular fractures recorded in the German Social Accident Insurance

Nico Hinz; Julius Dehoust; Klaus Seide; Birgitt Kowald; Stefan Mangelsdorf; Karl-Heinz Frosch; Maximilian J Hartel

doi:10.1016/j.injury.2023.110848

Epidemiology and socioeconomic consequences of work-related pelvic and acetabular fractures recorded in the German Social Accident Insurance

Injury. 2023 Aug;54(8):110848. doi: 10.1016/j.injury.2023.110848. Epub 2023 May 24.

Authors

Nico Hinz¹, Julius Dehoust², Klaus Seide³, Birgitt Kowald⁴, Stefan Mangelsdorf⁵, Karl-Heinz Frosch⁶, Maximilian J Hartel⁶

Affiliations

¹ Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany. Electronic address: n.hinz@bgk-hamburg.de.
² Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany.
³ Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany; Laboratory for Biomechanics, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany.
⁴ Laboratory for Biomechanics, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany.
⁵ Hochschule der DGUV (HGU) - University of Applied Sciences, Seilerweg 54, 10117 Bad Hersfeld, Germany.
⁶ Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Bergedorfer Strasse 10, 21033 Hamburg, Germany; Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.

PMID: 37258403
DOI: 10.1016/j.injury.2023.110848

Abstract

Introduction: Pelvic and acetabular fractures can result from work-related accidents and frequently require lengthy medical treatments. Consequently, high medical costs as well as delayed or absent return to work can be the consequence. Therefore, we aimed to study the socioeconomic consequences of work-related pelvic and acetabular fractures.

Materials and methods: This retrospective study investigated work-related pelvic and acetabular fractures recorded in the German Social Accident Insurance in 2011 and 2017, in terms of age, sex, type of accident, duration of incapacity to work, reductions in earning capacity, costs for outpatient and inpatient treatment and costs for pension and severance pay.

Results: Among a total of 606 injuries in 2011 and 619 injuries in 2017, male patients and patients between 40 and 65 years were predominantly affected. Acetabular fractures caused higher rates of long absence from work of 6-12 months (2011: 24.7% vs. 9.5-16.9%; 2017: 26.1% vs. 6.1-11.0%) and >12 months (2011: 15.8% vs. 9.8-10.2%; 2017: 13.3% vs. 1.9-8.2%) as well as more cases with a reduction in earning capacity of at least 20% (2011: 61 vs. ≤27 cases; 2017: 39 vs. ≤12 cases) compared to pelvic ring fractures. The total costs for pelvic ring and acetabular fractures in the German social accident insurances amounted € 18,726,630 and € 9637,189 in the periods 2011-2020 and 2017-2020, respectively. The average costs per case for treatment and rehabilitation until 2020 was € 19,079 for injuries from 2011 and € 13,629 for injuries from 2017. Acetabular fractures were found to be the most cost-intensive injuries compared to anterior, posterior or complex pelvic ring fractures.

Conclusions: Work-related pelvic and especially acetabular fractures have a considerable socioeconomic impact in the German Social Accident Insurance. Measures to prevent work-related accidents and to improve treatment of pelvic injuries can help to reduce their socioeconomic burden.

Keywords: Acetabular fractures; Cost analysis; Pelvic fractures; Socioeconomics; Work-related accidents.

MeSH terms

Accidents
Acetabulum / injuries
Fractures, Bone* / etiology
Hip Fractures* / complications
Humans
Insurance, Accident
Male
Pelvic Bones* / injuries
Retrospective Studies
Socioeconomic Factors
Spinal Fractures* / complications