Impact of the use of absorbable fracture fixation implants on consumption of hospital resources and economic costs.

Within a 6-year period (1984-1989) absorbable pins, rods, and screws made of polyglycolide, polylactide, or lactide-glycolide copolymer were used in the internal fixation of 881 fractures, 73.1% of which were displaced malleolar fractures of the ankle. During the last 3 years the patients treated using absorbable fracture fixation constituted 19.6% of all fracture patients managed by internal fixation at the department. The number of hardware removal procedures avoided during the 6-year period as a result of the use of the absorbable implants was estimated at approximately 700. By determining all direct and indirect costs associated with internal fracture fixation and the influence of the percentage of hardware removal, a cost coefficient was calculated for certain fracture types when treated using absorbable versus metallic internal fixation. In bimalleolar fractures, an optimal indication for absorbable fixation, the coefficient was 1.04 (cost of absorbable fixation 4% higher than that of metallic fixation) if the removal percentage with metallic fixation was zero and 0.91 (cost of absorbable fixation 9% lower than that of metallic fixation) if the removal percentage was 100%. The breakeven point was a removal rate of 31%.