Health economics for intra-capsular hip fractures undertaking fixation  

作　　者：Anatole Wiik Thomas Ashdown Ian Holloway 

机构地区：[1]Department of Surgery,Trauma and Orthopaedics,London North West University Healthcare,London HA13UJ,United Kingdom [2]Department of Surgery,Trauma and Orthopaedics,London North West University Hospital,London HA13UJ,United Kingdom

出　　处：《World Journal of Orthopedics》2024年第1期30-38,共9页世界骨科杂志（英文版）

摘　　要：BACKGROUND Hip fracture is a common musculoskeletal injury in the elderly requiring surgery worldwide.The operative mainstay of intra-capsular hip fractures is arthroplasty with a smaller proportion for fixation.AIM To determine the most beneficial method of fixation for patients with intracapsular hip fractures.METHODS A registered audit from 2012-2018 was conducted on all intra-capsular hip fractures treated with 2 commonly used fixation methods.Patient notes,electronic records and clinical codes for cost benefit were evaluated.A validated quality of life measure was collected at least 1 year after surgery.RESULTS A total of 83 patients were identified with intra-capsular fractures undergoing fixation during the retrospective period.There were 47 cannulated cancellous screw and 36 sliding hip screw fixations with the case mix comparable for age,gender,co-morbidities and fracture configuration.There was no significant difference in blood loss,tip apex distance,radiation exposure,length of stay,radiological union time,collapse,avascular necrosis or re-operation between fixation methods.Logistic regression analysis demonstrated displaced intracapsular hip fractures correlated significantly with an undesirable outcome conferring a relative odds ratio of 7.25.There were 9(19%)and 4(11%)patients respectively,who required re-operation.There was no significant difference in health resource group tariff and implant cost with comparable EQ-5D and visual CONCLUSION No significant advantage was identified with differing fixation type,but irrespective there were a high number of patients requiring re-operation.This was predicted by initial fracture displacement and patient age.Arthroplasty may need to be carefully considered for health economics and patient benefit.

关 键 词：Hip fracture FIXATION Patient reported outcome measure COST 

分 类 号：R687.3[医药卫生—骨科学]