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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

No cost difference between single or dual implants for distal femur fractures in the perioperative period.

Tyler Thorne, Makoa Mau, Eleanor Sato, Zarek Da Silva, Timothy Torrez, Michael Amick, Kayla Gates, Chong Zhang, Richard Nelson, Angela Presson and 1 more

Abstract readComparative Study
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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Tyler ThorneDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA.
Makoa MauDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA. mkktmau@hawaii.edu.
Eleanor SatoDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA.
Zarek Da SilvaDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA.
Timothy TorrezDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA.
Michael AmickDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA.
Kayla GatesDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA.
Chong ZhangDepartment of Internal Medicine, Division Epidemiology, University of Utah, Salt Lake City, USA.
Richard NelsonDepartment of Internal Medicine, Division Epidemiology, University of Utah, Salt Lake City, USA.
Angela PressonDepartment of Internal Medicine, Division Epidemiology, University of Utah, Salt Lake City, USA.
Justin HallerDepartment of Orthopaedic Surgery, University of Utah, Salt Lake City, USA. justin.haller@hsc.utah.edu.

Funding

University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health. UL1TR002538
6 · The paper itself

Abstract

purposeThis study uses a value-driven outcome model to assess the cost-effectiveness of single versus dual implants used in the fixation of distal femur fractures (DFF).

methodsA retrospective review identified all DFF treated at a level I trauma center between 2013 and 2023. Patients with open fractures, bilateral fractures, multiple injuries, and less than six months of cost-data or follow-up were excluded. DFF were divided into fixation by an intramedullary nail (IMN), lateral plate (LP), or dual construct (DC) including IMN and plate or dual plating. Cost data included all costs, including implant, facility, and operative costs associated with initial surgery and subsequent admissions associated with the injury. Actual cost data were analyzed via an inverse Gaussian regression model.

resultsOf 293 cases, 123 were treated by IMN, 133 by LP, and 37 by DC. There was no demographic, BMI, Charlson Comorbidity Index (CCI), or Injury Severity score (ISS) differences between groups. DC DFF tended to be AO Type C (27%) or periprosthetic fractures (35%) (p < 0.001). DC was 47% more expensive than IMN and 43% more expensive than LP at initial surgery (p < 0.001) and 46% more expensive than IMN and 40% more costly than LP downstream (p < 0.001). However, when controlling for age, BMI, fracture classification, and ISS, there was no difference in total cost across fixation types.

conclusionThe total cost for dual construct fixation of distal femur fractures was similar to intramedullary nailing or lateral plating despite higher initial costs and use in more complex fracture patterns.

Indexed as

Bone PlatesFemoral FracturesFracture Fixation, InternalFracture Fixation, IntramedullaryAdultAgedBone NailsCost-Benefit AnalysisFemaleFemoral Fractures, DistalHumansMaleMiddle AgedPerioperative PeriodRetrospective StudiesTrauma CentersDistal femur fractureDual implantSingle implantTotal direct costValue driven outcomes

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