Cost Comparison of Tibial Distraction Osteogenesis Using External Lengthening and Then Nailing vs Internal Magnetic Lengthening Nails.

IF 1 Q3 ORTHOPEDICS Strategies in Trauma and Limb Reconstruction Pub Date : 2021-01-01 DOI:10.5005/jp-journals-10080-1513

Aleksey Dvorzhinskiy, David T Zhang, Austin T Fragomen, S Robert Rozbruch

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引用次数: 3

Abstract

Aim and objective: Tibial lengthening can be performed by distraction osteogenesis via lengthening and then nailing (LATN) or by using a magnetic lengthening nail (MLN). MLN avoids the complications of external fixation while providing accurate and easily controlled lengthening. Concerns exist still regarding the high upfront cost of the magnetic nail, which serves to limit its use in resource-poor areas and decrease adoption among cost-conscious surgeons. The purpose of this study was to compare the hospital, surgeon, and total cost between LATN and MLN when used for tibial lengthening.

Materials and methods: A retrospective review was performed comparing consecutive tibial lengthening using either LATN (n = 17) or MLN (n = 15). The number of surgical procedures and time to union were compared. Surgeon and hospital payments were used to perform cost analysis after adjusting for inflation using the consumer price index (CPI).

Results: Patients treated with MLN underwent fewer surgeries (3.6 vs 2.8; p < 0.001) but had a longer time to union as compared with patients treated with LATN (19.79 vs 27.84 weeks; p = 0.006). Total costs were similar ($50,345 vs $46,162; p = 0.249) although surgeon fees were lower for MLN as compared with LATN ($6,426 vs $4,428; p < 0.001).

Conclusion: LATN and MLN had similar overall costs in patients undergoing tibial lengthening. MLN was associated with fewer procedures but a longer time to union as compared with LATN.

Clinical significance: Despite an increased upfront cost in MLN, there was no difference in total cost between LATN and MLN when used for tibial lengthening. Thus, in cases where either method is feasible, cost may not be a deciding factor when selecting the appropriate treatment.

How to cite this article: Dvorzhinskiy A, Zhang DT, Fragomen AT, et al. Cost Comparison of Tibial Distraction Osteogenesis Using External Lengthening and Then Nailing vs Internal Magnetic Lengthening Nails. Strategies Trauma Limb Reconstr 2021;16(1):14-19.

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胫骨牵张成骨外延长后内钉与磁性延长内钉的成本比较。

目的和目的:胫骨延长可以通过牵张成骨通过延长然后钉(LATN)或使用磁性延长钉(MLN)进行。MLN避免了外固定的并发症，同时提供准确和易于控制的延长。人们仍然担心磁性钉的前期费用过高，这限制了其在资源贫乏地区的使用，并减少了对成本敏感的外科医生的采用。本研究的目的是比较LATN和MLN用于胫骨延长时的医院、外科医生和总成本。材料和方法:回顾性分析了使用LATN (n = 17)和MLN (n = 15)进行连续胫骨延长的比较。比较手术次数和愈合时间。外科医生和医院的支付被用来进行成本分析后，调整通货膨胀使用消费者价格指数(CPI)。结果:MLN患者的手术次数较少(3.6 vs 2.8;p < 0.001)，但与LATN治疗的患者相比，愈合时间更长(19.79周vs 27.84周;P = 0.006)。总成本相似(50345美元vs 46,162美元;p = 0.249)，尽管MLN的外科医生费用较LATN低(6426美元对4428美元;P < 0.001)。结论:在接受胫骨延长的患者中，LATN和MLN的总成本相似。与LATN相比，MLN的手术较少，但愈合时间较长。临床意义:尽管MLN的前期成本增加，但当用于胫骨延长时，LATN和MLN的总成本没有差异。因此，在任何一种方法都可行的情况下，在选择适当的治疗方法时，成本可能不是决定因素。引用方式:Dvorzhinskiy A, Zhang DT, Fragomen AT，等。胫骨牵张成骨外延长后内钉与磁性延长内钉的成本比较。创伤肢体重建2021;16(1):14-19。

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

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1.50

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期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.