Fones Lilah, O'Mara Lauren C, Gallant Gregory, Kwok Moody, Abboudi Jack, Beredjiklian Pedro
Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, USA.
Division of Hand Surgery, Rothman Orthopaedic Institute, Philadelphia, USA.
Cureus. 2024 Feb 25;16(2):e54875. doi: 10.7759/cureus.54875. eCollection 2024 Feb.
Background Many distal radius fractures are treated with a volar locking plate, but a minority undergo dorsal bridge plate fixation. This study's primary purpose was to compare therapy utilization following distal radius fractures treated with traditional open reduction and internal fixation (ORIF) versus dorsal bridge plate fixation. Secondary outcomes were time to first and last therapy visits and therapy costs. Methods Patients over 18 years old who underwent distal radius ORIF between January 2021 and August 2022 at a single regional orthopedic practice were identified. Patients who underwent post-operative hardware removal were retrospectively reviewed to identify dorsal bridge plate fixation patients. This resulted in "traditional ORIF" and "dorsal bridge plate" groups. Therapy visit number, cost, and payor (insurance type including Medicare, private insurance, worker's compensation, automobile policy, and private pay) were collected. Results In total, 1,376 patients met the inclusion criteria. Of these, 713 of the 1,283 (55.6%) patients in the traditional ORIF group and 25 of the 44 patients (56.8%) in the dorsal bridge plate group attended therapy at our institution. Traditional ORIF and dorsal bridge plate patients averaged 12.6(±10) and 24(±18.7) therapy visits in the one-year following ORIF, respectively. Time to last therapy visit was 90.9(±60) and 175.2(±72.1) days in the traditional ORIF and dorsal bridge plate groups, respectively. Total therapy cost was $1,219(±$1,314) and $2,015(±$1,828) in the traditional ORIF and dorsal bridge plate groups with similar out-of-pocket costs. Conclusions Dorsal bridge plate fixation patients attended a greater number of therapy sessions, had a longer time from surgery until therapy end, and had a higher therapy total cost relative to traditional ORIF, but both groups had similar patient out-of-pocket therapy costs.
许多桡骨远端骨折采用掌侧锁定钢板治疗，但少数采用背侧桥接钢板固定。本研究的主要目的是比较传统切开复位内固定（ORIF）与背侧桥接钢板固定治疗桡骨远端骨折后的治疗利用情况。次要结果是首次和末次治疗就诊时间以及治疗费用。方法：确定2021年1月至2022年8月在单一地区骨科诊所接受桡骨远端ORIF治疗的18岁以上患者。对接受术后内固定取出的患者进行回顾性审查，以确定背侧桥接钢板固定患者。这形成了“传统ORIF”组和“背侧桥接钢板”组。收集治疗就诊次数、费用和支付方（保险类型，包括医疗保险、私人保险、工伤赔偿保险、汽车保险和自费）。结果：共有1376名患者符合纳入标准。其中，传统ORIF组1283例患者中的713例（55.6%）和背侧桥接钢板组44例患者中的25例（56.8%）在本机构接受治疗。传统ORIF组和背侧桥接钢板组患者在ORIF后的一年内平均分别接受12.6（±10）次和24（±18.7）次治疗。传统ORIF组和背侧桥接钢板组末次治疗就诊时间分别为90.9（±60）天和175.2（±72.1）天。传统ORIF组和背侧桥接钢板组的总治疗费用分别为1219美元（±1314美元）和2015美元（± 1828美元），自付费用相似。结论：与传统ORIF相比，背侧桥接钢板固定患者接受的治疗次数更多，从手术到治疗结束的时间更长，治疗总费用更高，但两组患者的自付治疗费用相似。
