Foot (Edinburgh, Scotland) · 2026
Tubular versus anatomically contoured low-profile plate fixation of Weber B fibula fractures: A threshold-cost analysis based on rates of hardware removal.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bernstein David N, Guild Theodore T, Kwon John Y
Аннотация
BACKGROUND: While anatomically contoured low-profile plates (ACLPPs) are more expensive when compared to tubular plates for ankle fracture fixation, this may not capture the entirety of relevant costs. We aimed to conduct a threshold-cost analysis to determine the frequency of hardware removal that would make ACLPPs cost-effective despite increased implant cost.
METHODS: In this threshold-cost analysis study, three orthopaedic implant companies provided list prices of ACLPPs, tubular 7-hole plates, 3.5 mm non-locking screws, and 3.5 mm locking screws. The constructs that were compared were: a 7-hole ACLPP, three 3.5 mm non-locking screws, and three 3.5 mm locking screws versus tubular 7-hole plate, three 3.5 mm non-locking screws, and three 3.5 mm locking screws. Surgical time for ROH was estimated at 20, 40, and 60 min. The ROH rate of the tubular plate constructs needed for cost equivalence with ACLPPs was determined assuming a "best case" 0% ACLPP construct ROH rate and ROH rates reported in the literature (lowest:1.6%; highest:39.9%; mean:12.2%).
RESULTS: Tubular plate construct cost ranged from £ 1,096-to-£ 2616 ($1,477-to-$3526) compared to £ 1,764-to-£ 4273 ($2,377-to-$5758) for ACLPP construct cost. Assuming a "best case" assumption of 0% ACLPP construct ROH rate, the tubular plate construct ROH rate needed to break-even ranged from 32% to not possible (i.e., >100% ROH rate). Under the same assumptions, when construct cost data were averaged across all three companies, no ROH rate for ACLPP constructs would be cost-effective at 20-minutes of surgical time; ROH rates of 76% and 51% would make the ACLPP constructs cost-effective at 40-minute and 60-minute surgical times, respectively. All tubular plate ROH rates to determine cost break-even increased when reported ACLPP construct ROH rates in the literature were utilized.
CONCLUSION: An exceedingly high ROH rate was required to justify the additional upfront cost of ACLPPs over traditional tubular plates when assuming comparable clinical efficacy at initial open reduction and internal fixation.
LEVEL OF EVIDENCE: III.
METHODS: In this threshold-cost analysis study, three orthopaedic implant companies provided list prices of ACLPPs, tubular 7-hole plates, 3.5 mm non-locking screws, and 3.5 mm locking screws. The constructs that were compared were: a 7-hole ACLPP, three 3.5 mm non-locking screws, and three 3.5 mm locking screws versus tubular 7-hole plate, three 3.5 mm non-locking screws, and three 3.5 mm locking screws. Surgical time for ROH was estimated at 20, 40, and 60 min. The ROH rate of the tubular plate constructs needed for cost equivalence with ACLPPs was determined assuming a "best case" 0% ACLPP construct ROH rate and ROH rates reported in the literature (lowest:1.6%; highest:39.9%; mean:12.2%).
RESULTS: Tubular plate construct cost ranged from £ 1,096-to-£ 2616 ($1,477-to-$3526) compared to £ 1,764-to-£ 4273 ($2,377-to-$5758) for ACLPP construct cost. Assuming a "best case" assumption of 0% ACLPP construct ROH rate, the tubular plate construct ROH rate needed to break-even ranged from 32% to not possible (i.e., >100% ROH rate). Under the same assumptions, when construct cost data were averaged across all three companies, no ROH rate for ACLPP constructs would be cost-effective at 20-minutes of surgical time; ROH rates of 76% and 51% would make the ACLPP constructs cost-effective at 40-minute and 60-minute surgical times, respectively. All tubular plate ROH rates to determine cost break-even increased when reported ACLPP construct ROH rates in the literature were utilized.
CONCLUSION: An exceedingly high ROH rate was required to justify the additional upfront cost of ACLPPs over traditional tubular plates when assuming comparable clinical efficacy at initial open reduction and internal fixation.
LEVEL OF EVIDENCE: III.