The Cost of Pediatric Distal Humerus Fractures
A TRUVEN Database study
DOI:
https://doi.org/10.55576/job.v3i4.44Keywords:
Supracondylar humerus fracture, lateral condyle fracture, medial epicondyle fracture, pediatric elbow, TRUVEN, ORIF, CRPP, Cost AnalysisAbstract
Objectives: The purpose of this study was to identify demographic properties, treatment selections, and cost information for pediatric supracondylar humerus, lateral condyle and medial epicondyle fractures.
Setting: IBM Truven MarketScan® Commercial and Medicare Supplemental databases.
Participants: Patients ages 17 years and younger with the ICD 9 and 10 codes for supracondylar humerus fractures, lateral condyle fractures, and medial epicondyle fractures between the years 2015 to 2020.
Interventions: Nonoperative, CRPP, and ORIF.
Main Outcomes: Treatment modality and cost of treatment.
Results: A total of 1,133 supracondylar, 154 lateral condyle, and 124 medial epicondyle fractures were identified. Supracondylar had the highest percent operative at 83%, followed by 78% lateral condyle and then 41% medial epicondyle. For both supracondylar and lateral condyle fractures the CRPP group was about two years younger than the ORIF group. Cost was higher for supracondylar ORIF as compared to CRPP ($1601.12 [1186.98-2146.63] vs. $1289.60 [978.75-1748.59]). Operative medial epicondyle patients were the oldest, followed by lateral condyle and finally supracondylar. Lateral condyles were about $300 more expensive than medial epicondyle operative fixation.
Conclusions: Within this insurance claims database, age was associated with the pediatric distal humerus fracture type and treatment modality. Patients receiving open reduction internal fixation were not only older on average but also accrued more costs than closed reduction percutaneous pinning by about $300. Medial epicondyle fractures tended to be the least expensive operative fixation and lateral condyle fracture fixation the most expensive.
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