Abstract:
OBJECTIVE:To evaluate the cost-effectiveness of screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in low-demand elderly patients. METHODS:We constructed a Markov decision model using a low-demand, 80-year-old patient as the base case. Costs, health-state utilities, mortality rates, and transition probabilities were obtained from published literature. The simulation model was cycled until all patients were deceased to estimate lifetime costs and quality-adjusted life years (QALYs). The primary outcome was the incremental cost-effectiveness ratio with a willingness-to-pay threshold set at $100,000 per QALY. We performed sensitivity analyses to assess our parameter assumptions. RESULTS:For the base case, hemiarthroplasty was associated with greater quality of life (2.96 QALYs) compared with screw fixation (2.73 QALYs) with lower cost ($23,467 vs. $25,356). Cost per QALY for hemiarthroplasty was $7925 compared with $9303 in screw fixation. Hemiarthroplasty provided better outcomes at lower cost, indicating dominance over screw fixation. CONCLUSIONS:Hemiarthroplasty is a cost-effective option compared with screw fixation for the treatment of nondisplaced femoral neck fractures in the low-demand elderly. Medical comorbidities and other factors that impact perioperative mortality should also be considered in the treatment decision. LEVEL OF EVIDENCE:Economic Level III. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Yong TM,Austin DC,Molloy IB,Kunkel ST,Jevsevar DS,Gitajn ILdoi
10.1097/BOT.0000000000001747subject
Has Abstractpub_date
2020-07-01 00:00:00pages
348-355issue
7eissn
0890-5339issn
1531-2291journal_volume
34pub_type
杂志文章abstract::We present a rare case of complete talar extrusion after trauma. Treatment of this severe injury remains controversial as a result of the lack of congruent evidence-based literature, associated high complication rate with primary repair, and difficulty in objectively assessing long-term outcomes. Recent small sampled ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318210f236
更新日期:2011-11-01 00:00:00
abstract::Healthcare policy has changed drastically, and with the 50-year anniversary of the passage of Medicare approaching in 2015, the authors evaluate the development of the current healthcare system and its relationship to the development of modern orthopaedic trauma. With more changes in healthcare policy forthcoming, it ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000214
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic reliability, sensitivity, and specificity of the Hawkins sign. The Hawkins sign is a subchondral radiolucent band in the talar dome that is indicative of viability at 6 to 8 weeks after a talus fracture. It is visible in the anterior-posterior view, but seldom appears on lateral ra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318148c665
更新日期:2007-09-01 00:00:00
abstract::In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000718
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:Residual dysfunction after pelvic trauma has been previously described, but limited functional outcome data are available in the female population after high-energy pelvic ring injury. The purposes of this study were to determine functional outcomes and to characterize factors predictive of outcome. DESIGN:...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318221e94e
更新日期:2012-05-01 00:00:00
abstract::Although opioids are widely used for the management of pain in patients with hip fracture, these medications are known to have a wide range of adverse effects that can result in suboptimal outcomes or serious life-threatening complications. Common opioid-related adverse events include gastrointestinal effects, central...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000563
更新日期:2016-05-01 00:00:00
abstract:INTRODUCTION:External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose d...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000817
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:The diagnosis and treatment of syndesmotic ankle fractures is controversial. This systematic review was performed to clarify the current understanding addressing several clinical questions that arise in the treatment of such injuries. DATA SOURCES:The English language literature was searched using PubMed, E...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000937
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the reduction and outcome of selected intraarticular calcaneal fractures treated with percutaneous Essex-Lopresti reduction and fixation. DESIGN:Prospective consecutive series. SETTING:Level one trauma center and tertiary university hospital. PATIENTS/PARTICIPANTS:Twenty-six consecutive patien...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199809000-00007
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVES:To compare open reduction and internal fixation (ORIF) and nonsurgical treatment outcomes in displaced midshaft clavicle fractures. DATA SOURCES:PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched in September 2017. STUDY SELECTION:Inclusion criteria were randomi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析
doi:10.1097/BOT.0000000000001174
更新日期:2018-07-01 00:00:00
abstract::Monteggia fractures represent approximately 1 to 2 percent of forearm fractures, whereas Galeazzi fractures represent 3 to 6 percent. The combination of these injuries in the same extremity is an exceedingly rare occurrence. We report a case of ipsilateral combination Monteggia and Galeazzi fractures in an adult patie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00011
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To quantify intrapelvic surface symmetry in reference to a preshaped suprapectineal acetabular implant. METHODS:In this cross-sectional study, an anatomically preshaped acetabular fracture implant was fitted on 3D surface models of 516 pelvises from a preexisting bone database using a software tool for autom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001373
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61-B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes. DESIGN:Database review. SETTING:L...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000130
更新日期:2014-12-01 00:00:00
abstract::Operative management of patella fractures continues to be associated with poor outcomes and high reoperation rates. Traditionally, tension band fixation has been used for more simple fracture patterns; however, fixation remains a challenge particularly for comminuted fractures. More recently, various types of plate fi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000908
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation. DESIGN:Retrospective review of medical care and surgical outcome from August 2006 to December 2008 using patient records for initial data with active...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318225e8d0
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:There are an estimated 1.2 million deaths from road traffic injuries annually, disproportionately affecting patients in low-resource settings. The purpose of this scoping review is to identify knowledge gaps in global orthopaedic trauma in an effort to help prioritize future research. METHODS:Using the 6-stage...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001293
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:The incidence of osteoporotic proximal tibial fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000004
更新日期:2014-05-01 00:00:00
abstract::Tibial plateau fractures can involve planes that require reduction and stabilization from a posterior approach. This includes posteromedial, posterolateral, and posterior column shear type injuries. This video outlines the prone posteromedial approach to the tibial plateau for posterior column fracture exposure, reduc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001826
更新日期:2020-08-01 00:00:00
abstract::We used a mathematical model to determine whether the approach to derotation of the malrotated femur can be improved for use in corrective osteotomy of the femur. Rotational corrective osteotomy of the femur (RCOF) is a procedure performed by orthopedic surgeons to correct congenital femoral torsion deformities and po...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199806000-00012
更新日期:1998-06-01 00:00:00
abstract::Road traffic accidents are a leading cause of global mortality. In March 2010, the United Nations General Assembly and the World Health Organization (WHO) officially proclaimed 2011-2020 as the "Decade of Action for Road Safety." Researchers must focus on vulnerable road users and low- and middle-income countries (LMI...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000103
更新日期:2014-01-01 00:00:00
abstract::This study was done to determine whether fixation with the Uppsala internal fixation technique into the subchondral bone of the femoral head in the treatment of cervical hip fractures could lead to elevation of the femoral head cartilage. Combined arthrography and frontal tomography of the hip joint in the plane of th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198909000-00004
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To report on the anatomic variations of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection. DESIGN:Cadaveric anatomic study. PATIENTS/PARTICIPANTS:Sixty-eight ilioinguinal dissections performed in fifty cadavers. INTERVENTION:The lateral femoral cutaneous nerve was ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199901000-00005
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To compare failure rates between short and long cephalomedullary nails used for the treatment of intertrochanteric hip fractures in patients over 65 years of age. DESIGN:Retrospective cohort study. Data were collected from medical records and radiographs. SETTING:Three level 1 trauma centers. PATIENTS/PAR...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000036
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:A new device for the treatment of intertrochanteric fractures that uses 2 cephalocervical screws in an integrated mechanism allowing linear intraoperative compression and rotational stability of the head/neck fragment has been developed. The aim of this study was to describe the results using this device for ...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0b013e31819211b2
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:With the transition to a value-based model of care delivery, bundled payment models have been implemented with demonstrated success in elective lower extremity joint arthroplasty. Yet, hip fracture outcomes are dependent on patient-level factors that may not be optimized preoperatively due to acuity of care....
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001454
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:To compare the Disability of the Arm, Shoulder, and Hand (DASH) and Constant scores, time to union, rate of union, patient cosmetic satisfaction rate, and the need for secondary procedures between 2.7- and 3.5-mm anteroinferior plating for Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma A...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182693f32
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:Heterotopic ossification (HO) develops frequently after modern high-energy penetrating war injuries. The purpose of this prospective study was to identify and characterize the unique cytokine and chemokine profile associated with the development of HO as it pertained to the systemic inflammatory response afte...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31825d60a5
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:Because locked plates as a neutralization device for lag screw fracture fixation have different biomechanics than that of unlocked plates, we investigated how this would affect lag screw load at the fracture site. The purpose of this study was to assess the load at a fracture site compressed with a lag screw...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31823b3dd1
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of patients with posterolateral tibial plateau fractures after open reduction and internal fixation with a fibula osteotomy-free posterolateral approach. DESIGN:Retrospective chart and operation note review. SETTING:A medical college-affiliated tertiary hospital. MATERIALS AND METHO...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000047
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Hip fractures are associated with significant morbidity and mortality. Co-management models pairing orthopaedic surgeons with hospitalists or geriatricians may be effective at improving processes of care and outcomes such as length of stay (LOS) and cost. We set out to determine the effect of an integrated h...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000691
更新日期:2016-12-01 00:00:00