Costs and health-related quality of life of non-operative and surgical treatment modalities for displaced distal radius fractures: a comprehensive overview based on the CAST study.
Britt Barvelink, Stella C M Heemskerk, Jan A N Verhaar et al.
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In 30 seconds
This cost and health-related quality-of-life analysis used data from the multicenter cluster-randomized CAST trial of adults with displaced distal radius fractures. It compared non-operative care, direct plate fixation, and delayed plate fixation after fracture redisplacement. Among 693 patients, estimated mean total societal costs per patient were €2,212, €4,339, and €4,393, respectively. HRQoL improved between 3 and 12 months in all groups, but did not return to pre-injury levels in every group. The authors describe non-operative treatment as least costly and suggest it may be reasonable to decide on surgery later according to alignment changes.
Key findings
- Estimated mean total costs per patient were €2,212 with non-operative treatment, €4,339 with direct plate fixation, and €4,393 with delayed plate fixation.
- The reported cost difference between direct and delayed plate fixation was €58 in favor of direct fixation.
- HRQoL improved between 3 and 12 months in all groups but did not reach pre-injury levels in every group.
Why it matters
Treatment choices for displaced distal radius fractures involve both patient outcomes and societal costs. This analysis indicates that non-operative care had the lowest estimated costs, while HRQoL improved across treatment groups without consistently returning to pre-injury levels. These findings help frame the economic and recovery trade-offs when considering initial immobilization and possible later surgery.
What to keep in mind
This is a descriptive cost and HRQoL analysis of trial data, and treatment groups were not described as randomized comparisons of the three modalities.