title: Extracapsular hip fracture management: cost-consequences analysis of two alternative operative methods.
abstract: OBJECTIVE
  The aim of this prospective study was to perform a cost and outcome comparison between two alternative operative techniques (osteosynthesis and hemiarthroplasty) used in the treatment of elderly patients with unstable trochanteric hip fracture.
  
  
  METHODS
  One hundred seventy-three trochanteric hip fracture patients were followed-up for 1 year after surgery. For each operative technique, hospital treatment's cost per patient was computed. Mortality and complication rate in-hospital and at specific time points after surgery were used as outcome measures. Patients' functional level before and after hip fracture was estimated according to their mobility and ability to perform basic and instrumental activities of daily living.
  
  
  RESULTS
  The cost for patients undergoing osteosynthesis reached euro 1,931 per case, whereas for those treated with hemiarthroplasty reached euro 3,719 per case (2001 rates). There was no statistically significant difference regarding in-hospital mortality and complication rate, as well as mortality and complication rate 1 year after surgery, between the two patient groups.
  
  
  CONCLUSIONS
  The quite similar performance of the two operative techniques suggests that cost could be the key factor for choosing between them. However, it is critical that many more randomized studies, with larger sample sizes and wider follow-up time periods should be conducted.
authors.affiliation: University of Athens, Athens, Greece. bpapakost@nurs.uoa.gr
authors.forename: Vassiliki V
authors.initials: VV
authors.lastname: Papakonstantinou
authors.forename: Daphne
authors.initials: D
authors.lastname: Kaitelidou
authors.forename: Kassiani D
authors.initials: KD
authors.lastname: Gkolfinopoulou
authors.forename: Olga Ch
authors.initials: OCh
authors.lastname: Siskou
authors.forename: Theodoros
authors.initials: T
authors.lastname: Papapolychroniou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Baltopoulos
authors.forename: Lycourgos
authors.initials: L
authors.lastname: Liaropoulos
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D005593:Fracture Fixation, Internal / Q000191:economics; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000191:economics* / Q000379:methods*; D011183:Postoperative Complications / Q000191:economics; D011446:Prospective Studies