Abstract
Aims: The aim of this study was to compare the cost- effectiveness of surgical fixation with Kirschner (K-) wire ersus moulded casting after manipulation of a fracture of the distal radius in an operating theatre setting. Methods: An economic evaluation was conducted based on data collected from the Distal Radius Acute Fracture Fixation Trial 2 (DRAFFT2) multicentre randomized controlled trial in the UK. Resource use was collected at three, six, and 12 months post-randomization using trial case report forms and participant-completed questionnaires. Cost-effectiveness was reported in terms of incremental cost per quality-adjusted life year (QALY) gained from an NHS and personal social services perspective. Sensitivity analyses were conducted to examine the robustness of cost-effectiveness estimates, and decision uncertainty was handled using confidence ellipses and cost-effectiveness acceptability curves. Results: In the base case analysis, surgical fixation with K-wire was more expensive (£29.65 (95% confidence interval (CI) -94.85 to 154.15)) and generated lower QALYs (0.007 (95% CI -0.03 to 0.016)) than moulded casting, but this difference was not statistically significant. The probability of K-wire being cost-effective at a £20,000 per QALY cost-effectiveness threshold was 24%. The cost-effectiveness results remained robust in the sensitivity analyses. Conclusion: The findings suggest that surgical fixation with K-wire is unlikely to be a cost-effective alternative to a moulded cast in adults, following manipulation of a fracture of the distal radius in a theatre setting.
Original language | English |
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Pages (from-to) | 1225-1233 |
Number of pages | 9 |
Journal | Bone and Joint Journal |
Volume | 104 B |
Issue number | 11 |
Early online date | 1 Nov 2022 |
DOIs | |
Publication status | Published - 1 Nov 2022 |
Keywords
- Adult
- Bone Plates
- Bone Wires
- Cost-Benefit Analysis
- Fracture Fixation, Internal/methods
- Fracture Fixation/methods
- Fractures, Bone
- Humans
- Radius
- Radius Fractures/surgery