The Primary Cost Drivers of Outpatient Distal Radius Fracture Fixation: A Cost-Minimalization Analysis of 15,379 Cases

Abstract

Background Distal radius fractures are the most common fracture of the upper extremity. While some distal radius fractures can be managed with closed reduction and immobilization, operative treatment is the standard of care, with open reduction internal fixation (ORIF) as a predominant operative method. Questions/Purpose To investigate how patient and surgical characteristics affect the overall costs of internal fixation of distal radius fractures in adults. Patients and Methods The 2014 State Ambulatory Surgery and Services Databases for six states were used to identify cases and surgical characteristics of distal radius fracture ORIF in adult patients. Results Surgical variables that significantly increased cost were postoperative admission within 30 days, regional anesthesia, simultaneous endoscopic carpal tunnel release, and increasing operating room time. Conclusion Substantial contributors to total cost are postoperative hospital admission within 30 days of surgery, use of regional anesthesia, simultaneous endoscopic carpal tunnel release, and longer operative time. Level of Evidence Level III, retrospective cohort study.

Comment: Theca Primary Cost Drivers of Outpatient Distal Radius Fracture Fixation: A Cost-Minimalization Analysis of 15,379 Cases

“…We read this article with interest and agree with Hresko et al 1 on the influence of patient characteristics and operative technique on the overall costs of internal fixation of distal radius fractures in adults, including postoperative admission within 30 days.…”

“…We congratulate Hresko et al 1 for their very interesting article that shows the importance of medico-economic studies in the management of wrist fractures.…”

“…However, Hresko et al 1 considered their medico-economic study on the aspect of decreasing expenses for the health system in general. We believe that it is also important to approach the medico-economic studies on the aspect of increasing revenues for health care institutions in general.…”

“…The most telling example is indeed the type of anesthesia. Hresko et al 1 have shown that locoregional anesthesia is more expensive than general anesthesia. But, as they themselves say, the postoperative results are better under locoregional anesthesia than under general anesthesia.…”