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We present an economic evaluation using data from the Distal Radius Acute Fracture Fixation Trial (DRAFFT) to compare the relative cost effectiveness of percutaneous Kirschner wire (K-wire) fixation and volar locking-plate fixation for patients with dorsally-displaced fractures of the distal radius. The cost effectiveness analysis (cost per quality-adjusted life year; QALY) was derived from a multi-centre, two-arm, parallel group, assessor-blind, randomised controlled trial which took place in 18 trauma centres in the United Kingdom. Data from 460 patients were available for analysis, which includes both a National Health Service cost perspective including costs of surgery, implants and healthcare resource use over a 12-month period after surgery, and a societal perspective, which includes the cost of time off work and the need for additional private care. There was only a small difference in QALYs gained for patients treated with locking-plate fixation over those treated with K-wires. At a mean additional cost of £714 (95% confidence interval 588 to 865) per patient, locking-plate fixation presented an incremental cost effectiveness ratio (ICER) of £89,322 per QALY within the first 12 months of treatment. Sensitivity analyses were undertaken to assess the ICER of locking-plate fixation compared with K-wires. These were greater than £30,000. Compared with locking-plate fixation, K-wire fixation is a 'cost saving' intervention, with similar health benefits.

Original publication

DOI

10.1302/0301-620x.97b8.35234

Type

Journal article

Journal

The bone & joint journal

Publication Date

08/2015

Volume

97-B

Pages

1082 - 1089

Addresses

University of Leeds, 101 Clarendon Road, Leeds LS6 9LJ, UK.

Keywords

Humans, Radius Fractures, Length of Stay, Fracture Fixation, Internal, Bone Plates, Bone Wires, Quality-Adjusted Life Years, Cost-Benefit Analysis, State Medicine, Female, Male, Palmar Plate