Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania.
Department of Microbiology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq No 2, 300041 Timisoara, Romania.
Medicina (Kaunas). 2020 Feb 15;56(2):79. doi: 10.3390/medicina56020079.
: There are various methods in the management of forearm fractures in children. Elastic stable intramedullary nailing using Titanium Elastic Nail (TEN) is nowadays employed in diaphysis fractures of children, with clear benefits over other treatment options. However, in the case of TEN versus other treatment methods of forearm fractures in children, cost is an important issue. This report will focus on the cost assessment of using TEN versus other therapeutic means in the treatment of forearm fractures in children. : We performed a retrospective longitudinal study of 173 consecutive patients with forearm fractures treated in a single institution during 2017. We calculated the cost for each patient by summing up direct costs plus indirect costs, calculated at an aggregate level. Hospital income data were extracted from the Diagnosis Related Groups database. : A total of 173 patients with forearm fractures were treated, 44 using TEN, 86 using K-wire, and 46 using closed reduction and cast. There were 66 radius fractures, 1 ulna fracture, and 106 that were both radius and ulna fractures. Mean treatment cost were $632.76 for TEN, $499.50 for K-wire, and $451.30 for closed reduction and cast. Costs for TEN were higher than for K-wire insertion ( = 0.00) and higher than closed reduction and cast ($182.42; = 0.00). Reimbursement per patient was higher with TEN versus K-wire patients; $497.88 vs. $364.64 /patient ( = 0.00), and higher than for patients treated with closed reduction and cast ( = 0.00). : The treatment of upper extremity fractures using TEN was more expensive than the other methods. In Romania, because the reimbursement for TEN is higher as well, there are no differences in the financial burden when treating forearm fractures with TEN versus K-wire. Non-surgical treatment has the lowest cost but also the lowest reimbursement.
儿童前臂骨折的治疗方法多种多样。目前，在儿童骨干骨折中使用钛弹性钉（TEN）进行弹性稳定髓内钉固定，与其他治疗方法相比具有明显优势。然而，在 TEN 与儿童前臂骨折的其他治疗方法相比时，成本是一个重要问题。本报告将重点介绍 TEN 与儿童前臂骨折其他治疗方法的成本评估。
我们对 2017 年在一家机构接受治疗的 173 例连续前臂骨折患者进行了回顾性纵向研究。我们通过将直接成本加间接成本相加来计算每位患者的成本，并在总水平上进行计算。从诊断相关组数据库中提取医院收入数据。
共治疗 173 例前臂骨折患者，其中 44 例采用 TEN 治疗，86 例采用 K 型钉治疗，46 例采用闭合复位和石膏固定。66 例为桡骨骨折，1 例尺骨骨折，106 例为桡骨和尺骨骨折。TEN 的平均治疗费用为 632.76 美元，K 型钉为 499.50 美元，闭合复位和石膏固定为 451.30 美元。TEN 的费用高于 K 型钉（ = 0.00）和闭合复位和石膏固定（$182.42； = 0.00）。与 K 型钉患者相比，TEN 患者的每位患者报销费用更高；$497.88 比$364.64/患者（ = 0.00），高于闭合复位和石膏固定患者（ = 0.00）。
使用 TEN 治疗上肢骨折比其他方法更昂贵。在罗马尼亚，由于 TEN 的报销费用也更高，因此使用 TEN 和 K 型钉治疗前臂骨折的经济负担没有差异。非手术治疗费用最低，但报销也最低。
