Elsevier

Injury

Volume 31, Issue 4, May 2000, Pages 229-232
Injury

The cost of treatment of distal radial fractures

https://doi.org/10.1016/S0020-1383(99)00248-XGet rights and content

Abstract

In an increasingly cost conscious management of health care, estimating the cost of treatment of distal radial fractures has significant relevance. We studied 100 distal radial fractures, prospectively, from their presentation to eventual discharge. On an average, £320.50 were spent on each patient during 1997. Ninety percent of the costs were seen to be service costs and only 10% were those of consumables. A proportion of costs incurred due to remanipulations could have been saved by supervised primary treatment. Also, lack of protocols resulted in increased use of clinic time, physiotherapy sessions and radiographs. In-patient treatment was seen to account for the bulk of the expenditure. We have identified certain guidelines to improve the primary treatment of these fractures and the possibility of treating them in designated sessions in the day surgery unit. This is likely to reduce the overall cost of treatment of these very commonly sustained fractures though this will need to be proved in a future validated study.

Introduction

Osteoporotic fractures especially those of distal forearm, hip and vertebrae constitute a major public health problem [1], [2], [3]. The treatment of these fractures in the elderly presents a heavy workload both for the Accident and Emergency (A&E) and the Orthopaedic departments [3], [4]. Although distal radial fractures are one of the most extensively studied group of fractures, there are no studies to our knowledge evaluating the cost of their treatment. Such a study has an obvious relevance in an increasingly cost conscious management of healthcare.

The present study seeks to provide an estimate of the cost of treatment of these fractures, and explores methods to reduce the expenditure. It also aims to provide the doctors with costing information with the hope of changing their clinical behavior.

Section snippets

Material and methods

We collected detailed cost data on 100 consecutive distal radial fractures in people over the age of 60 years, prospectively between 1 February and 31 August 1997 treated as part of existing practice. These patients were first assessed in the A&E by the senior house officer (SHO) who manipulated these fractures under a haematoma block if it was felt appropriate. Due to logistical difficulties and the perceived difficulty in manipulating, some of these fractures were left till the next day for

Results

Amongst the 100 distal radial fractures, 98 were of the Colles' type whereas 2 were Smith's fractures. There were 92 women and 8 men in our study. The age distribution of our patients was as shown in Table 1.

All injuries were sustained due to trivial falls except one patient who was assaulted. There were three associated injuries that increased the hospital stay They have been enumerated in Table 2. The in-patient costs for these are not included in this study.

Forty-eight patients were treated

Discussion

In the era of resource management and cost containment, there is an increasing emphasis on the need to make the best possible use of available resources. We have selected distal radial fractures for our study, as these are one of the most common group of fractures encountered in orthopaedic practice.

The incidence of wrist fractures in women increases linearly between 40 and 65 years of age and then stabilizes [1]. In men, the incidence remains constant between 20 and 80 years [1]. Majority of

References (12)

  • S.J. Meyers et al.

    In patient cost of primary total joint arthroplasty

    J. Arthroplasty

    (1996)
  • Report of the advisory group on osteoporosis: Department of health. November...
  • Hollingworth W, Todd CJ, Parker MJ. The cost of treating hip fractures in the 21st century: short report. Osteoporosis...
  • (1996)
  • L.J. Donaldson et al.

    Incidence of fractures in a geographically defined population

    J. Epidemiol. Commun. Health

    (1990)
  • Zethraeus N, Stromberg L, Jonsson B, Svensson O, Ohlen G. The cost of a hip fracture: Estimates for 1709 patients in...
There are more references available in the full text version of this article.

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