From Indiana University School of Medicine, Indiana University Health Methodist Hospital, Indianapolis, IN (Dr. Virkus, Dr. McKinley, Dr. Sorkin, Dr. Cheesman), the Case Western Reserve University School of Medicine, Cleveland, OH (Dr. Wetzel), Indiana University Health Methodist Hospital, Indianapolis, IN (Ms. Hill), and Carolinas Medical Center, Charlotte, NC (Dr. Kempton).
J Am Acad Orthop Surg. 2018 Jun 15;26(12):e261-e268. doi: 10.5435/JAAOS-D-16-00687.
We evaluated the radiographic outcomes and surgical costs of surgically treated rotational ankle fractures in our health system between providers who had completed a trauma fellowship and those who had not.
We grouped patients into those treated by trauma-trained orthopaedic surgeons (TTOS) and non-trauma-trained orthopaedic surgeons (NTTOS). We graded the quality of fracture reductions and calculated implant-related costs of treatment.
A total of 208 fractures met the inclusion criteria, with 119 in the TTOS group and 89 in the NTTOS group. Five patients lost reduction during the follow-up period. The adequacy of fracture reduction at final follow-up did not differ (P = 0.29). The median surgical cost was $2,940 for the NTTOS group and $1,233 for the TTOS group (P < 0.001).
We found no notable differences in radiographic outcomes between the TTOS and NTTOS groups. Cost analysis demonstrated markedly higher implant-related costs for the NTTOS group, with the median surgical cost being more than twice that for the TTOS group.
Level III.
我们评估了在我们的医疗体系中，接受过创伤专科培训的骨科医生（TTOS）和未接受过创伤专科培训的骨科医生（NTTOS）治疗的旋转踝关节骨折的放射学结果和手术费用。
我们将患者分为接受过创伤专科培训的骨科医生（TTOS）和未接受过创伤专科培训的骨科医生（NTTOS）治疗的两组。我们对骨折复位的质量进行分级，并计算治疗相关的植入物费用。
共有 208 例骨折符合纳入标准，其中 TTOS 组 119 例，NTTOS 组 89 例。在随访期间有 5 例患者出现复位丢失。最终随访时骨折复位的充分性没有差异（P = 0.29）。NTTOS 组的手术费用中位数为 2940 美元，TTOS 组为 1233 美元（P < 0.001）。
我们在 TTOS 和 NTTOS 两组之间没有发现放射学结果的显著差异。成本分析显示，NTTOS 组的植入物相关费用明显更高，中位手术费用是 TTOS 组的两倍多。
III 级。
