Boston Children's Hospital, Department of Orthopaedic Surgery, Boston, Massachusetts.
Rainbow Babies and Children's Hospital, Department of Orthopaedic Surgery, Cleveland, Ohio.
J Surg Orthop Adv. 2021 Fall;30(3):181-184.
Research has demonstrated similar efficacy of drill epiphysiodesis and percutaneous epiphysiodesis using transphyseal screws for the management of adolescent leg length discrepancy. A cost analysis was performed to determine which procedure is more cost-effective. Patients seen for epiphysiodesis of the distal femur and/or proximal tibia and fibula between 2004 and 2017 were reviewed. A decision analysis model was used to compare costs. Two hundred thirty-five patients who underwent either drill (155/235, 66%) or screw (80/235, 34%) epiphysiodesis were analyzed with an average age at initial procedure of 13 years (range, 8.4 to 16.7 years). There was no significant difference in average initial procedure cost or total cost of all procedures across treatment groups (n = 184). The cost difference between drill and screw epiphysiodesis is minimal. In order for screw epiphysiodesis to be cost-favored, there would need to be a significant decrease in its cost or complication rate. (Journal of Surgical Orthopaedic Advances 30(3):181-184, 2021).
研究表明，在治疗青少年肢体长度差异方面，使用经骺板螺钉进行钻骺板固定术和经皮骺板固定术的疗效相似。进行了成本分析以确定哪种手术更具成本效益。对 2004 年至 2017 年间接受股骨远端和/或胫骨和腓骨骺板固定术的患者进行了回顾。使用决策分析模型来比较成本。分析了 235 例接受钻骺板固定术（155/235，66%）或螺钉骺板固定术（80/235，34%）的患者，初始手术的平均年龄为 13 岁（范围为 8.4 至 16.7 岁）。在治疗组中，初始手术的平均费用或所有手术的总费用没有显著差异（n=184）。钻骺板固定术和螺钉骺板固定术的成本差异很小。为了使螺钉骺板固定术具有成本优势，需要显著降低其成本或并发症发生率。（《外科矫形进展杂志》30(3):181-184, 2021）。
