78-Year-Old Employee Returns to Work After Complex Hip Fracture

Problem

A 78-year-old maintenance worker stepped off a scissor lift and broke his left hip near the joint (an intertrochanteric hip fracture). He had surgery the next day to realign the bone and secure it with metal hardware. During his first hospital stay, he developed blood clots in both lungs that required a procedure to remove them, and he also developed pneumonia. Four months later, follow-up imaging showed that the hardware in his hip had failed. Ten months after the first surgery, he needed another surgery to repair the upper part of his thigh bone (femur). These complications put him at real risk for long-term disability, higher medical costs, and uncoordinated care across several providers.

Solution

A field case management referral was initiated, playing a crucial role in addressing the injured employee’s complex medical needs and overcoming health care system barriers. The field case manager managed the hardware failure and blood clot by ensuring timely diagnostics, advocating for specialist referrals and ensuring a consistent medication regimen. Her efforts included:

• Optimizing therapy for age-related recovery challenges

• Securing medical records

• Coordinating care and transport

• Streamlining authorizations 

• Facilitating access to a host of providers

Outcome

The employee advanced to modified duty six weeks after the revision surgery and reached full duty with appropriate restrictions one month later. For the employer and insurer, interventions contained costs while improving the quality and continuity of care.

Why this matters to you

This case study demonstrates how field case management can lead to tighter reserves, fewer services needed and less time chasing logistics. The coordinated plan prevented unnecessary testing and duplicate services while guiding the employee to stable function with minimal pain. That led to clarity on next steps, faster movement to duty status and contained costs.