Failure after proximal humeral fracture osteosynthesis: a one year analysis of hospital-related healthcare cost

Abstract

Purpose The issue of rising healthcare costs and limited resources is a topic of worldwide discussion over the last several decades. We hypothesized that failure of proximal humeral fracture osteosynthesis is presumed to be an important determinant in healthcare resources and related costs. The aim of this study was to calculate the total hospital-related healthcare cost of proximal humeral fracture osteosynthesis over one year focusing on failure. Methods A total of 121 patients with a proximal humeral fracture treated by angular stable osteosynthesis were included in this retrospective study. All hospital-related healthcare costs were investigated. Five main hospital-related cost categories were defined: hospitalization cost, honoraria, day care admission, materials, and pharmaceuticals. Results A total healthcare cost of € 1,139,448 was calculated for the whole patient group. Twelve patients needed revision surgery due to complications or fixation-related failure. This failure rate alone costed € 190,809 of the healthcare resources. In other words, failure after proximal humeral fracture osteosynthesis costed 17% of the total healthcare expenditure inone year. Conclusion This study demonstrates that a high amount of hospital-related healthcare resources is spent because of failure after proximal humeral fracture osteosynthesis. Further research is necessary and should investigate on how to prevent failure. This is not only in the patient’s interest, but it is also of great importance for maintaining a healthy healthcare system.

Recent Progress in Surface Modification of Mg Alloys for Biodegradable Orthopedic Applications

“…During the anodization process, the Mg-substrate that acts as the anode gets oxidized, forming a protective oxide film on the surface. The formed coating generally has a nanostructured oxide layer with a thickness of up to 25 µm that can be controlled by changing anodization time, current density, and electrolytic concentration (de Oliveira et al, 2020;Mohan et al, 2020). Cipriano et al (2017) performed anodization of pure Mg using 10 M KOH as the electrolyte at three different potentials (1.8, 1.9, and 2.0 V).…”

“…The surface characteristics are expected to promote osteointegration and degrade at a rate compatible with tissue growth. The degradable implant can reduce the costs of health care and the chances for acquired infections due to repeated hospital visits (Khan et al, 2016;Dauwe et al, 2020;Herteleer et al, 2021;Xi et al, 2021). Figure 1 summarizes the current limitations that can be addressed by developing a suitable biodegradable metallic material.…”

Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up

“…Proximal humeral fractures (PHFs) induce pain and limitations in activities of daily living (ADL), and reduce quality of life (QoL) [1,2]. In addition, PHFs produce relevant direct costs including medical costs: the hospitalization cost is the most important factor in total healthcare cost of PHFs, being 55% of the total healthcare costs [3]. Despite exact estimates of indirect costs not being available, presumably long-term loss of earnings, vocational rehabilitation expenditures, pensions and wagereplacement costs, production slowdowns, accident investigations, and finally, the recruiting and training of workers to replace those injured are also expected [4].…”

“…Subsequently, nonoperative treatments are recommended, usually based on immobilization and then on rehabilitation [6,7]. An efficient return-to-work time is also recommended to decrease individual and company costs [3].…”

Reverse total shoulder arthroplasty with a humeral inclination of 135º for treatment of 3- and 4-part proximal humeral fractures: Clinical analysis with minimum follow-up of 2 years

“…Proximal humerus fractures are frequent, accounting for approximately 5% of all fractures in adults [1][2][3] and more than 10% in the elderly. The number of proximal humerus fractures will rise due to the growing of the elderly population (with accompanying osteoporosis, resulting in an even higher healthcare resource utilization).…”