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Open AccessArticle

Cost-Effectiveness of Titanium Elastic Nail (TEN) in the Treatment of Forearm Fractures in Children

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Department of Pediatric Surgery and Orthopedics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania
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Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Sq No 2, 300041 Timisoara, Romania
*
Authors to whom correspondence should be addressed.
Medicina 2020, 56(2), 79; https://doi.org/10.3390/medicina56020079
Received: 28 December 2019 / Revised: 11 February 2020 / Accepted: 13 February 2020 / Published: 15 February 2020
Background and objectives: There are various methods in the management of forearm fractures in children. Elastic stable intramedullary nailing using Titanium Elastic Nail (TEN) is nowadays employed in diaphysis fractures of children, with clear benefits over other treatment options. However, in the case of TEN versus other treatment methods of forearm fractures in children, cost is an important issue. This report will focus on the cost assessment of using TEN versus other therapeutic means in the treatment of forearm fractures in children. Materials and Methods: We performed a retrospective longitudinal study of 173 consecutive patients with forearm fractures treated in a single institution during 2017. We calculated the cost for each patient by summing up direct costs plus indirect costs, calculated at an aggregate level. Hospital income data were extracted from the Diagnosis Related Groups database. Results: A total of 173 patients with forearm fractures were treated, 44 using TEN, 86 using K-wire, and 46 using closed reduction and cast. There were 66 radius fractures, 1 ulna fracture, and 106 that were both radius and ulna fractures. Mean treatment cost were $632.76 for TEN, $499.50 for K-wire, and $451.30 for closed reduction and cast. Costs for TEN were higher than for K-wire insertion (p = 0.00) and higher than closed reduction and cast ($182.42; p = 0.00). Reimbursement per patient was higher with TEN versus K-wire patients; $497.88 vs. $364.64 /patient (p = 0.00), and higher than for patients treated with closed reduction and cast (p = 0.00). Conclusions: The treatment of upper extremity fractures using TEN was more expensive than the other methods. In Romania, because the reimbursement for TEN is higher as well, there are no differences in the financial burden when treating forearm fractures with TEN versus K-wire. Non-surgical treatment has the lowest cost but also the lowest reimbursement. View Full-Text
Keywords: forearm fractures; children; fracture treatment; titanium elastic nail; Pediatric orthopedics; cost analysis forearm fractures; children; fracture treatment; titanium elastic nail; Pediatric orthopedics; cost analysis
MDPI and ACS Style

Adam, O.; David, V.L.; Horhat, F.G.; Boia, E.S. Cost-Effectiveness of Titanium Elastic Nail (TEN) in the Treatment of Forearm Fractures in Children. Medicina 2020, 56, 79.

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