Generic Volar Locking Plate Use in Distal Radius Fractures: A Prospective Randomized Study to Evaluate Clinical Outcomes and Cost Reduction.

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-11-06 DOI:10.1177/15589447241293168
Stephen A Doxey, Rebekah M Kleinsmith, Lily J Qian, Jeffrey B Husband, Deborah C Bohn, Brian P Cunningham
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Abstract

Background: The purpose of this study was to evaluate differences in 90-day clinical outcomes between patients treated with generic volar locking plates (VLPs) and conventional VLPs in distal radius fractures. Secondary aims included assessing for differences in surgical characteristics and cost between the groups.

Methods: From November 2022 to April 2023, a prospective block-randomized study was undertaken in which surgeons alternated between using a generic VLP and a conventional VLP each month. The institution's chargemaster database was cross-referenced for implant cost. Primary outcomes were 90-day readmission, reoperation, and mortality rates. Secondary outcomes included estimated blood loss, tourniquet time, and implant cost.

Results: A total of 66 patients were included. Most were women (n = 61, 92.4%), with an average age of 61.0 ± 11.5 years. There were no significant differences in age, sex, smoking status, AO Foundation/Orthopaedic Trauma Association classification, or tourniquet time between patients who received generic and conventional implants. The average total cost was higher with conventional implants than generic implants($1348.61 ± 100.77 and $702.38 ± 47.83, respectively; P < .001). The largest difference in cost came from pegs and screws that were used ($640.77 ± 90.93 vs $268.47 ± 45.93, P < .001). No patients experienced complications such as readmission, reoperation, or death within 90 days.

Conclusions: Total implant cost was lower for procedures where generic VLPs were used. Cost differences between generic and conventional implants are driven by the variable selection of pegs and screws. With no differences in 90-day outcomes, surgeons may consider using generic implants as a way of increasing the value of care delivery.

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在桡骨远端骨折中使用通用沃尔锁定钢板:评估临床疗效和降低成本的前瞻性随机研究。
背景:本研究的目的是评估桡骨远端骨折患者使用通用型椎体锁定钢板(VLP)和传统型椎体锁定钢板治疗后90天临床疗效的差异。次要目的包括评估两组患者在手术特征和费用方面的差异:从2022年11月到2023年4月,开展了一项前瞻性整群随机研究,外科医生每月交替使用普通VLP和传统VLP。该机构的收费数据库与植入成本进行了交叉对比。主要结果是 90 天再入院率、再手术率和死亡率。次要结果包括估计失血量、止血带时间和植入成本:结果:共纳入 66 名患者。大多数患者为女性(n = 61,92.4%),平均年龄(61.0 ± 11.5)岁。接受普通植入物和传统植入物的患者在年龄、性别、吸烟状况、AO 基金会/矫形创伤协会分类或止血带时间方面没有明显差异。常规植入物的平均总成本高于普通植入物(分别为 1348.61 美元 ± 100.77 和 702.38 美元 ± 47.83;P < .001)。最大的成本差异来自使用的钉和螺钉(640.77 美元 ± 90.93 对 268.47 美元 ± 45.93,P < .001)。没有患者在90天内出现再次入院、再次手术或死亡等并发症:结论:使用普通 VLP 的手术植入总成本较低。结论:使用非专利 VLP 的手术总费用较低,非专利植入物和传统植入物之间的成本差异主要是由于对钉和螺钉的选择不同造成的。由于 90 天内的结果没有差异,外科医生可以考虑使用普通植入物来提高医疗服务的价值。
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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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