The reuse of circular external fixator components: an assessment of safety and potential savings

Abstract

Cost saving strategies are important especially in a resource constrained environment. One such strategy well supported in literature is the reuse of temporary monolateral external fixator components, a strategy we utilize at our institution. The aim of the study was to determine the safety and cost saving associated with the reuse of definitive circular external fixator components in a resource constrained environment. Method:We performed a retrospective review of all adult patients who were treated with either new or reused circular external fixators from a single manufacturer between January and December 2017. Reused circular external fixator components, excluding half pins and wires, were subjected to an in-house reprocessing protocol. Cost savings were calculated as the difference between the price of a completely new frame and the amount invoiced for new components only in a reused frame.Results: 33 patients were included in the study with an average age of 31.9 years. The mean duration of treatment with a circular external fixator was 5.8 months. No mechanical failure events were recorded during the study period. Our institution saved approximately 52% (R717 503.89) and 63 % (R136 568.19) of expected total cost for hexapod and Ilizarov frames respectively. Conclusion:The strategy of reusing circular external fixator components is unconventional and this study was conducted to evaluate the safety and potential savings in a resource constrained environment. We demonstrated this practice to be reasonably safe and to result in significant cost savings which might be relevant in low-and-middle income countries (LMICs).

Mechanical Analysis of a Novel 3D-printed External Fixator Design Versus Industry-standard External Fixators

“…The cost for printing the 3D-printed 100% infill external fixator used in this study was $14.49 (USD), Failure mode (Disp j Force j Break) 6 j 0 j 0 6 j 0 j 0 6j 0 j 0 6j 0 j 0 0j 0 j 6 1j 0 j 5 AP Rigidity (N/mm) 97. 3 Failure mode (Disp j Force j Break) 6 j 0 j 0 6 j 0 j 0 6j 0 j 0 6j 0 j 0 3j 0 j 3 6j 0 j 0 Failure mode (Disp j Force j Break) 6 j 0 j 0 6 j 0 j 0 6j 0 j 0 6j 0 j 0 1j 0 j 5 3j 0 j 3 significantly lower than commercially available external fixation devices costing thousands of dollars in the United States. The printer used in this study costs $650 USD, and 2 kg of PLA filament costs approximately $20 USD.…”

“…2 In the United States, external fixators are typically sold as single-use devices; however, some components may be able to be reused in humanitarian efforts to decrease costs associated with their use. 3 These donated sets are in very limited supply and difficult to deliver and store. 4 There is a need for innovative solutions to make external fixation devices more affordable and available, especially in developing countries and remote locations with underserved access to specialized orthopaedic care.…”