Long Gamma nail versus short Gamma nail in the treatment of stable intertrochanteric fractures

Is it worth it? A cost benefit analysis and a systematic review

Daniel Markowicz, Jared M. Newman, Sun Jin Kim, Mickey Plymale, Andrew Lovy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The short Gamma nail (Stryker, Mahwah, NJ) is a commonly used device for the treatment of stable intertrochanteric hip fractures. First generation Gamma nails have been complicated by fractures at the tip of the nail. The long Gamma nail has been shown to reduce the incidence of periprosthetic fractures. The purpose of this metaanalysis was to compare the cost-effectiveness of the long Gamma nail as an alternative to second and third generation short Gamma nails as the initial treatment of stable intertrochanteric fractures. Methods: Using MEDLINE via PubMed, all articles published in the English language between January 2000 and May 2007 that included the key words "trochanteric gamma," "long gamma," "hip," "intertrochanteric," and "gamma" were reviewed. A manual search of the reference list of each paper also was performed. Five papers fit these criteria. Gross costs were estimated from Medicare reimbursement data for the relevant Diagnosis-Related Group codes plus published costs for Current Procedural Terminology code. Results: Three hundred and twenty-nine short Gamma nails implanted were reviewed, and a total of two periprosthetic fractures were reported. Cost analysis demonstrated that a total cost of acute care hospitalization and a year of rehabilitation equals an additional $26,076,659.80 for the treatment of periprosthetic fractures with short Gamma nails as compared with the projected cost of initially treating primarily with long Gamma nails. Conclusions: The periprosthetic fracture rate of short Gamma nails in this meta-analysis suggests that the use of the long Gamma nail as the primary treatment for all stable intertrochanteric hip fractures is a cost-effective treatment.

Original languageEnglish (US)
Pages (from-to)347-351
Number of pages5
JournalCurrent Orthopaedic Practice
Volume25
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Hip Fractures
Nails
Cost-Benefit Analysis
Periprosthetic Fractures
Costs and Cost Analysis
Therapeutics
Current Procedural Terminology
Diagnosis-Related Groups
Medicare
PubMed
MEDLINE
Health Care Costs
Meta-Analysis
Hip
Hospitalization
Language
Rehabilitation
Equipment and Supplies

Keywords

  • Gamma
  • Hip
  • Intertrochanteric
  • Long gamma
  • Nail
  • Trochanteric gamma

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Long Gamma nail versus short Gamma nail in the treatment of stable intertrochanteric fractures : Is it worth it? A cost benefit analysis and a systematic review. / Markowicz, Daniel; Newman, Jared M.; Kim, Sun Jin; Plymale, Mickey; Lovy, Andrew.

In: Current Orthopaedic Practice, Vol. 25, No. 4, 2014, p. 347-351.

Research output: Contribution to journalArticle

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