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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Lack of Surgeon Standardization on Implant Selection in Ankle Fracture Fixation May Increase Costs and Decrease

David N Bernstein1, Philip Hanna1, Nelson Merchan1

  • 1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Foot & Ankle Specialist
|June 18, 2021
PubMed
Summary
This summary is machine-generated.

Surgical standardization in ankle fracture fixation is crucial. Lack of standardization among surgeons leads to significant variations in implant costs, impacting overall financial outcomes.

Keywords:
ORIFankle fracturecontribution margincostsreimbursementvalue-based health care

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Area of Science:

  • Orthopedic Surgery
  • Health Economics
  • Surgical Outcomes

Background:

  • Surgical standardization can reduce costs without compromising patient care.
  • Limited research exists on the financial impact of standardization in ankle fracture fixation.
  • Ankle fractures are common injuries requiring surgical intervention.

Purpose of the Study:

  • To analyze the financial impact of surgical standardization in ankle fracture fixation.
  • To identify variations in implant costs associated with different surgeons and fracture types.
  • To determine the relationship between surgeon practice and hardware expenses.

Main Methods:

  • Retrospective analysis of 168 patients with isolated ankle fractures undergoing open reduction, internal fixation (ORIF).
  • Financial data were analyzed based on fracture classification, implant type, and surgeon.
  • Bivariate analyses, ANOVA, and linear regression were used to assess cost differences.

Main Results:

  • Significant differences in implant costs were observed across surgeons (P < .001).
  • The use of suture buttons or locking plates was associated with higher implant costs ($1014 vs $338, P < .001).
  • Surgeons 3 and 4 showed a significant association with higher hardware costs (P = .043 and P < .001, respectively).

Conclusions:

  • Substantial variation in implant costs exists even for similar ankle fracture types.
  • Lack of standardization among surgeons resulted in a nearly 3.5-fold cost difference.
  • Non-standardized surgical practices negatively impact the contribution margin in ankle fracture fixation.