Liu Haonan, He Liang, Zhang Guilin, Gong Xiaofeng, Li Ning
Medical Center, Tsinghua University, Beijing 100083, China.
Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China.
J Orthop Sci. 2017 Jan;22(1):75-80. doi: 10.1016/j.jos.2016.08.015. Epub 2016 Sep 29.
There is very little information on the costs of different surgeries for displaced femoral neck fractures. This study aimed to compare the costs between internal fixation and hemiarthroplasty (HA) in the treatment of displaced femoral neck fracture.
A total of 142 patients aged 65 years or older who had been randomized into internal fixation group (n = 70) or HA group (n = 72) were followed for 2 years. Cost data was collected through hospitalization information, cost diary and telephone interview. Sensitivity analysis was performed for missing diaries. The total costs were collected and compared between the two groups.
All diaries were completed by 69.7% of patients. The mean costs of primary treatment were significantly lower for internal fixation (CNY 21,631) compared with HA (CNY 51,641) (p < 0.001). The mean post-discharge costs were similar for both procedures: CNY 37,377 for internal fixation and CNY 34,981 for HA (p = 0.640). The mean total costs for internal fixation were CNY 59,008, which was significantly lower than the mean total costs of CNY 86,622 for HA (p = 0.002).
Although the post-discharge costs of internal fixation were slightly higher, the total costs were still lower than for HA due to great variance in costs of primary treatment. In China, internal fixation may be less costly than HA for displaced femoral neck fracture treatment.
关于移位型股骨颈骨折不同手术的费用信息非常少。本研究旨在比较内固定与半髋关节置换术（HA）治疗移位型股骨颈骨折的费用。
将142例65岁及以上的患者随机分为内固定组（n = 70）或HA组（n = 72），随访2年。通过住院信息、费用日记和电话访谈收集费用数据。对缺失的日记进行敏感性分析。收集两组的总费用并进行比较。
69.7%的患者完成了所有日记。内固定的初始治疗平均费用（21,631元人民币）显著低于HA（51,641元人民币）（p < 0.001）。两种手术出院后的平均费用相似：内固定为37,377元人民币，HA为34,981元人民币（p = 0.640）。内固定的平均总费用为59,008元人民币，显著低于HA的平均总费用86,622元人民币（p = 0.002）。
尽管内固定出院后的费用略高，但由于初始治疗费用差异很大，其总费用仍低于HA。在中国，内固定治疗移位型股骨颈骨折的费用可能低于HA。
