title: Cast treatment and intramedullary locking nailing for simple and spiral wedge tibial shaft fractures--a cost benefit analysis.
abstract: OBJECTIVE
  The aim of this retrospective study was to compare the relative costs of treating simple and spiral wedge (requiring closed reduction under anaesthesia) tibial shaft fractures in a plaster cast or with intramedullary locking nail.
  
  
  METHODS
  The material consisted of 26 fractures treated in a plaster cast and 51 fractures treated with an intramedullary locking nail. The costs caused by the direct costs (treatment, hospitalisation, and outpatient appointments) as well as indirect costs (lost productivity) were taken into account. Costs caused by complications were also included in the analysis.
  
  
  RESULTS
  Mean direct costs per patient were FIM 22920 and FIM 26952 and mean overall costs per patient were FIM 120486 and FIM 82224 in plaster cast and intramedullary locking nailing groups, respectively (FIM 1 = USD 0.19). The higher mean overall costs of the plaster cast group were attributable to the longer sick leave periods in this group (218 days in plaster cast group and 124 in intramedullary nailing group).
  
  
  CONCLUSIONS
  Plaster cast treatment of simple and spiral wedge tibial shaft fractures requiring closed reduction under anaesthesia is more expensive to society than operative treatment with intramedullary locking nail.
authors.affiliation: Section of Orthopaedics and Traumatology, Department of Surgery, Tampere University Hospital, Finland. lljato@uta.fi
authors.forename: J A
authors.initials: JA
authors.lastname: Toivanen
authors.forename: M
authors.initials: M
authors.lastname: Hirvonen
authors.forename: O
authors.initials: O
authors.lastname: Auvinen
authors.forename: S E
authors.initials: SE
authors.lastname: Honkonen
authors.forename: T L
authors.initials: TL
authors.lastname: Järvinen
authors.forename: A M
authors.initials: AM
authors.lastname: Koivisto
authors.forename: M J
authors.initials: MJ
authors.lastname: Järvinen
mesh_terms: D000328:Adult; D001858:Bone Nails; D002370:Casts, Surgical / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005387:Finland; D005594:Fracture Fixation, Intramedullary / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*