title: Staged Columnar Fixation of Bicondylar Tibial Plateaus: A Cheaper Alternative to External Fixation.
abstract: The objective of this study was to compare complication rates and costs of staged columnar fixation (SCF) to external fixation for bicondylar tibial plateau fractures. Patients who received SCF or temporary external fixation across a 3-year period at a major level I trauma center underwent a retrospective chart review for associated complications. Fisher's exact analysis was used to determine any statistical difference in complication rates between both groups. However, there was no significant difference in complication rates between the SCF and external fixator groups. Average medial plate costs for SCF were $2131 compared with an average external fixator cost of $4070 (p < .0001). Given that all patients with external fixation undergo eventual medial and lateral plating, savings with SCF include $4070 plus operative costs for removing the fixator. As our health care system focuses on cost-cutting efforts, orthopaedic trauma surgeons must explore cheaper and equally effective treatment alternatives.
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, Vanderbilt University, Nashville, Tennessee.
authors.forename: Aaron
authors.initials: A
authors.lastname: Perdue
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Greenberg
authors.forename: Vasanth
authors.initials: V
authors.lastname: Sathiyakumar
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Thakore
authors.forename: Hassan R
authors.initials: HR
authors.lastname: Mir
authors.forename: William T
authors.initials: WT
authors.lastname: Obremskey
authors.forename: Manish K
authors.initials: MK
authors.lastname: Sethi
mesh_terms: D001860:Bone Plates / Q000191:economics; D015331:Cohort Studies; D016267:External Fixators / Q000191:economics; D005260:Female; D005592:Fracture Fixation / Q000191:economics / Q000379:methods; D005593:Fracture Fixation, Internal / Q000191:economics / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome