Objective To compare the clinical efficacy and total cost of operation and conservative treatment for unstable distal radius fractures in elderly patients,and to provide evidence for clinicians to choose effective treatment.Methods A total of 88 elderly patients with unstable distal radius fractures who were admitted to Fuyang Orthopaedics and Traumatology Affiliated Hospital of Zhejiang Chinese Medical University from December 2019 to March 2023 were included in the study.According to the therapeutic methods,they were divided into operation group(n=44)and splint group(n=44).The cost of outpatient review during hospitalization and 1 year after treatment,gartland-werlery(GW),patient-rated wrist evaluation(PRWE),imaging examination,and complications were recorded.The cost-effectiveness ratio(CER)and incremental cost-effectiveness ratio(ICER)were studied from the perspective of health economics.Results There was no significant difference in the recovery rate of wrist joint function and PRWE score between two groups(P>0.05).After 1 year follow-up,the imaging parameters of both groups were improved.Comparison of imaging parameters between the two groups showed statistically significant difference(P<0.05).The total complication rate of operation group was lower than that of splint group(P<0.05).The total cost and hospitalization cost of operation group were(23 080.71±2 180.37)and(23 728.35±2 246.57)yuan,respectively,which were higher than that of splint group(5 333.80±1 843.87)and(6 614.61±1 763.00)yuan(P<0.05).However,the outpatient cost was lower than that of splint group(P<0.05).The cost-effectiveness ratio(CER)of operation group and splint group was 1 383.51 yuan/points and 3 31.89 yuan/points,respectively.Compared with the splint group,the surgery group cost 5 648.10 yuan more for every 1 point reduction in PRWE score.Conclusion In patients>60 years of age with unstable distal radius fractures,splinting and open reduction are both effective,but the former may be a more cost-effective treatment option.
关键词
老年/不稳定型桡骨远端骨折/切开复位内固定/闭合复位夹板固定/成本-效果比/增量成本-效果比
Key words
older/unstable distal radial fractures/open reduction and internal fixation/closed reduction and splint immobilization/cost-effectiveness ratio/incremental cost-effectiveness ratio
维普
万方数据