John D. Hewitt M.D., Craig T Haytmanek M.D., Joshua N. Tennant M.D., Ryan C. May M.S., Selene G. Parekh M.D. MBA

Current Orthopaedic Practice, 22(6), 534–537

Background: Ankle fractures are common injuries and many have indications for operative treatment. Newer plate designs have recently been introduced and have the potential to simplify and shorten the operative procedure. This study compared the cost of operative treatment of a lateral malleolar fracture between a novel plate design and a neutralization plate and lag screw approach.

Methods: A retrospective chart review was performed with institutional review board approval. All patients operatively treated for a Weber B lateral malleolar fracture were divided into two cohorts: an experimental group treated with a novel plate and a control group treated with a lag screw and neutralization plate. Cost of implants, operating room costs, and time of healing were compared between the two cohorts.

Results: The average implant cost for the novel plate design ($1,141) was significantly higher than that of the plate and lag screw construct ($208) (p < 0.0001). The average operating room costs were significantly lower for the experimental group ($4,410) compared to the control group ($6, 037) (p <0.01). The average time to union was significantly less in the experimental group (75 days) than in the control group (97 days) (p < 0.04).

Conclusions: Use of a novel plate design in this study was associated with decreased operating room costs and a quicker time to union compared to the use of a traditional construct. This may result reduced amounts of dissection required to apply the novel plate and a more favorable biological environment for bone healing. The additional cost of new implant designs may be justified by quicker, simpler operative techniques, and enhanced healing.
Level of evidence: Therapeautic Level III