Socioeconomic impact of upper and lower extremity fractures among temporary migrant workers: A prospective longitudinal cohort study.

Injury · Oct 13 2026 · Recent

Lari A, Mohammad H, Bahbahani R, Alenezi N, AlQattan A, Alherz M

Department of Orthopedic Surgery, Al Razi Orthopedic Hospital, Kuwait

Orthopaedic Trauma

SUMMARY — THE REDUCTIONIn 430 migrant workers in Kuwait with limb fractures, 23% had complete income loss at 12 months, with worse losses in physically demanding or self-employed workers and those with multiple fractures.
Abstract, as published

BACKGROUND: Temporary migrant workers may be particularly vulnerable to financial and occupational consequences after fracture. This study evaluated longitudinal income changes and socioeconomic outcomes following appendicular fractures in this population.

METHODS: This prospective cohort study included temporary migrant workers in Kuwait aged 18-65 years presenting with appendicular fractures between January 2023 and January 2025. Pre-injury income and income at 1, 3, 6 and 12 months were recorded and expressed as a percentage of individual baseline income. Unadjusted and exploratory multivariable analyses examined complete income loss at 12 months.

RESULTS: Of 601 patients assessed, 430 were included. Complete income loss affected 19.1% at 1 month, peaked at 35.1% at 3 months and persisted in 23.3% at 12 months. Mean income retained at 12 months was 65.8% of baseline: 55.5% in physically demanding labour versus 80.1% in professional roles. By 12 months, 77.0% had returned to work, but 58.0% of returners earned less than before injury. Self-employment (adjusted OR 3.02; 95% CI 1.57-5.82) and multiple fractures (2.21; 1.25-3.92) remained associated with complete income loss after adjustment; the occupational association was attenuated.

CONCLUSION: Appendicular fractures were followed by persistent socioeconomic disruption, with greater observed income deficits among physically demanding and self-employed workers and those with more extensive injuries. Returners often remained below baseline income at 12 months. Recovery assessment should include income and occupational stability.

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