Ankle fractures are common injuries, and many have clear indications for operative treatment. Newer plate designs have recently been introduced and have the potential to simplify and shorten the operative procedure. This study compares the costs of operative treatment of a lateral malleolar fracture using a novel plate design or a neutralization plate and lag screw approach.
A retrospective chart review was performed. All patients operatively treated for a Weber B lateral malleolar fracture were divided into two cohorts: an experimental group treated with a novel plate design and a control group treated with a lag screw and neutralization plate. Costs of implants, operating room costs and time to healing were compared between the two cohorts.
The average implant cost for the novel plate design ($1141) was significantly higher than that of the plate and lag screw construct ($208; P<0.0001). The average operating room costs were significantly lower for the experimental group ($4410) compared with the control group ($6037; P<0.01). The average time to healing was significantly less in the experimental group (75 days) than in the control group (97 days; P<0.04).
The decreased operating room costs likely resulted from attributes of the novel plate design that assist in fracture reduction and eliminate the need for a separate lag screw. The decreased dissection required to apply the novel plate could explain the quicker healing observed. The additional cost of new implant designs may be justified by quicker, simpler operative techniques and enhanced healing.
aDivision of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina
bDepartment of Orthopaedic Surgery, University of North Carolina, Chapel Hill, North Carolina
cDepartment of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
dFuqua School of Business, Duke University, Durham, North Carolina
Dr. Parekh is a consultant for Orthohelix, Biomet, Memometal, Kyphon, and Invuity and receives research support from Trimed and Orthohelix.
The authors declare no conflict of interest.
Correspondence to: Selene G. Parekh, MD, MBA, 3609 Southwest Durham Drive, Durham, NC 27707 Tel: +919 471 9622; fax: +919 477 1929; e-mail: firstname.lastname@example.org.