[Direct medical cost of late rehabilitation in workers with conservatively managed proximal humerus fracture].

Acta ortopedica mexicana Pub Date : 2022-01-01
B I Navarrete-Peñaloza, H Hernández-Amaro
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Abstract

Introduction: Eighty percent of the Proximal humerus fractures are not displaced or minimally displaced and stable. The international treatment recommendation is conservative. Immobilization of the limb carries risk of stiffness, pain and decreased function. Currently being used rehabilitation programs with early mobilization of the injured shoulder within the first week post-fracture, with evidence of early functional and labor recovery and with no risk for displacement of fragments. However, in our country, these patients start rehabilitation late, which leads to a delay in the recovery of functionality and delay in returning to work, translating into increased costs. At the moment there is no national benchmark for the cost of this late-onset rehabilitation.

Material and methods: From a non-probabilistic sample for convenience, were analyzed records of 52 patients, treated in the period from January to December 2019. Inclusion criteria were workers diagnosed with a proximal humeral fracture, conservative management; exclusion criteria were peripheral nerve injury, aggregate fracture or surgically treated.

Results: The mean direct medical cost was $19,090.69 Mexican pesos, directly proportional to the days of stay in the unit and disability.

Conclusion: Late rehabilitation leads to more days of disability than recommended by the based guidelinesin the workload, therefore, higher cost.

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保守治疗肱骨近端骨折工人后期康复的直接医疗费用
80%的肱骨近端骨折不移位或轻度移位且稳定。国际上的治疗建议是保守的。固定肢体有僵硬、疼痛和功能下降的风险。目前使用的康复方案是在骨折后的第一周内早期活动受伤的肩膀,有证据表明早期功能和劳动恢复,没有碎片移位的风险。然而,在我国,这些患者开始康复较晚,导致功能恢复和重返工作岗位的延迟,转化为成本增加。目前,对于这种迟发性康复的费用,还没有全国性的基准。材料和方法:为方便起见,从非概率样本中分析2019年1月至12月期间治疗的52例患者的记录。入选标准为确诊肱骨近端骨折的工人,保守治疗;排除标准为周围神经损伤、骨性骨折或手术治疗。结果:平均直接医疗费用为19,090.69墨西哥比索,与住院天数和残疾成正比。结论:在工作量上,延迟康复导致的残疾天数比基础指南推荐的要多,因此成本更高。
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