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Study: Stability critical in determining most cost-effective fixation method
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According to recently published results, the most cost-effective method of fixation for hip fractures depends on the stability of the fracture.
Researchers analyzed an expected-value decision-analysis model designed to estimate the costs and health utility of a sliding hip screw and an intramedullary (IM) nail for intertrochanteric hip fracture fixation. Scenarios this model evaluated included fractures that were stable, unstable and those where stability was uncertain. Model validity was tested via sensitivity analysis. Pertinent literature provided fixation failure rates and other critical data.
There was not one method determined as most cost-effective for all scenarios. Sliding hip screws were more cost-effective for stable fractures, whereas IM nails were most cost-effective for fractures with uncertain stability. For unstable fractures, the sliding hip screw was most cost-effective in 70% of cases; however, this was highly sensitive to the failure rate, according to the researchers.
Implant cost and fixation failure rate were found to be the two primary factors in deciding on an implant.
Disclosure: One or more of the authors, or his or her institution, has had a financial relationship, in the 36 months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work.
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