Walter Nike, Neubauer Ines, Baertl Susanne, Alt Volker, Rupp Markus
Department for Trauma Surgery, University Hospital Regensburg, Regensburg.
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Gießen, Germany.
JB JS Open Access. 2025 Aug 22;10(3). doi: 10.2106/JBJS.OA.24.00133. eCollection 2025 Jul-Sep.
Fracture-related infections (FRIs) pose significant clinical and economic challenges in trauma surgery. Despite advancements in treatment modalities, the economic burden of managing FRIs remains substantial. However, cost analyses are scarce. Therefore, the aim of this study was to analyze the direct healthcare costs associated with FRI treatment compared with initial fracture treatment across various fracture types in a level 1 trauma center in Germany.
A retrospective analysis of 95 patients treated for fractures and FRIs between 2013 and 2020 was conducted. Patients were categorized based on the fracture location: femur, tibia, ankle, and foot. Data collected included fracture characteristics, and costs related to both initial fracture treatment and FRI management. Costs were analyzed using diagnosis-related group (DRG) reimbursement data. The mean DRG reimbursement for initial fracture treatment and FRI treatment was compared to determine the economic impact of FRIs.
The study revealed significant increases in costs for FRI treatment across all fracture types. For femur fractures, the mean reimbursement for initial treatment was €17,617.66, while FRI treatment costs were €31,731.49, resulting in a difference of €14,113.83 and a 1.8-fold increase in costs. Tibia fractures showed an increase from €10,327.70 to €28,024.38 (difference of €17,696.68, 2.7-fold increase of costs). Ankle fractures had a cost increase from €3,790.38 to €17,940.90 (difference of €14,150.52, 4.7-fold increase of costs), and foot fractures showed an increase from €6,557.95 to €23,272.48 (difference of €16,714.53, 3.5-fold increase of costs).
The costs for FRI treatment are substantially higher than those for initial fracture management across all fracture types studied. These findings emphasize the need for effective preventive measures and efficient management protocols to reduce the incidence and financial impact of FRIs.
Level III. See Instructions for Authors for a complete description of levels of evidence.
骨折相关感染（FRI）在创伤外科中带来了重大的临床和经济挑战。尽管治疗方式有所进步，但管理FRI的经济负担仍然很大。然而，成本分析却很匮乏。因此，本研究的目的是在德国一家一级创伤中心分析与FRI治疗相关的直接医疗成本，并与各种骨折类型的初始骨折治疗成本进行比较。
对2013年至2020年间95例接受骨折和FRI治疗的患者进行回顾性分析。患者根据骨折部位进行分类：股骨、胫骨、踝关节和足部。收集的数据包括骨折特征以及与初始骨折治疗和FRI管理相关的成本。使用诊断相关组（DRG）报销数据对成本进行分析。比较初始骨折治疗和FRI治疗的平均DRG报销金额，以确定FRI的经济影响。
研究表明，所有骨折类型的FRI治疗成本均显著增加。对于股骨骨折，初始治疗的平均报销金额为17,617.66欧元，而FRI治疗成本为31,731.49欧元，差额为14,113.83欧元，成本增加了1.8倍。胫骨骨折的成本从10,327.70欧元增加到28,024.38欧元（差额为17,696.68欧元，成本增加了2.7倍）。踝关节骨折的成本从3,790.38欧元增加到17,940.90欧元（差额为14,150.52欧元，成本增加了4.7倍），足部骨折的成本从6,557.95欧元增加到23,272.48欧元（差额为16,714.53欧元，成本增加了3.5倍）。
在所研究的所有骨折类型中，FRI治疗的成本显著高于初始骨折管理的成本。这些发现强调需要采取有效的预防措施和高效的管理方案，以降低FRI的发生率和经济影响。
三级。有关证据水平的完整描述，请参阅作者指南。
