Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 5/2022

23.10.2020 | Original Article

Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies

verfasst von: Michiel Herteleer, Celien Van Brandt, Cindy Vandoren, Stefaan Nijs, Harm Hoekstra

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We describe the incidence of tibial plateau fractures and the evolution of its management and financial burden in Belgium, perform a similar audit at University Hospitals Leuven, and define strategies to curb the increasing cost.

Methods

National data on tibial plateau fractures were collected from the NIHDI and compared to our performance. Several clinical parameters, such as age, sex, treatment modality and length-of-stay, were included. The total healthcare costs are considered as the sum of hospitalization costs and ambulatory care costs.

Results

Between 2006 and 2018, a total number of 35,226 tibial plateau fractures were diagnosed in Belgium and 861 at our center. The incidence increased 41% over time (mean 25/100,000 persons per year). The mean rate of surgery in Belgium was 37% and slightly decreased over time, due to a larger increase of non-operatively treated tibial plateau fractures. The rate of surgery at the UHL was 49%. Surprisingly, the average cost per patient was equal for operatively and non-operatively treated patients in Belgium, and driven by the length-of stay.

Conclusion

Since length-of-stay is the main driver of the total healthcare costs of tibial plateau fractures, guidelines on appropriate length-of-stay can help to decrease variability and curb the total healthcare costs, particularly of the non-operatively treated patients. Our performance was in line with this.

Level of evidence

Level IV.
Literatur
1.
Zurück zum Zitat Frattini M, Vaienti E, Soncini G, Pogliacomi F. Tibial plateau fractures in elderly patients. Chir Organi Mov. 2009;93:109–14.PubMed Frattini M, Vaienti E, Soncini G, Pogliacomi F. Tibial plateau fractures in elderly patients. Chir Organi Mov. 2009;93:109–14.PubMed
2.
Zurück zum Zitat Herteleer M, Hoekstra H, Nijs S. Diagnosis and treatment of clavicular fractures in Belgium between 2006 and 2015. J Shoulder Elb Surg. 2018;27:1512–8.CrossRef Herteleer M, Hoekstra H, Nijs S. Diagnosis and treatment of clavicular fractures in Belgium between 2006 and 2015. J Shoulder Elb Surg. 2018;27:1512–8.CrossRef
3.
Zurück zum Zitat Wennergren D, Bergdahl C, Ekelund J, Juto H, Sundfeldt M, Möller M. Epidemiology and incidence of tibia fractures in the Swedish fracture register. Injury. 2018;49:2068–74.CrossRef Wennergren D, Bergdahl C, Ekelund J, Juto H, Sundfeldt M, Möller M. Epidemiology and incidence of tibia fractures in the Swedish fracture register. Injury. 2018;49:2068–74.CrossRef
4.
Zurück zum Zitat van den Berg J, Reul M, Nunes Cardozo M, Starovoyt A, Geusens E, Nijs S, Hoekstra H. Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures. Int Orthop. 2017;41:1865–73.CrossRef van den Berg J, Reul M, Nunes Cardozo M, Starovoyt A, Geusens E, Nijs S, Hoekstra H. Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures. Int Orthop. 2017;41:1865–73.CrossRef
5.
Zurück zum Zitat Metsemakers WJ, Smeets B, Nijs S, Hoekstra H. Infection after fracture fixation of the tibia: analysis of healthcare utilization and related costs. Injury. 2017;48:1204–10.CrossRef Metsemakers WJ, Smeets B, Nijs S, Hoekstra H. Infection after fracture fixation of the tibia: analysis of healthcare utilization and related costs. Injury. 2017;48:1204–10.CrossRef
6.
Zurück zum Zitat Oladeji L, Worley J, Crist B. Age-related variances in patients with tibial plateau fractures. J Knee Surg. 2019;33:611–5.PubMed Oladeji L, Worley J, Crist B. Age-related variances in patients with tibial plateau fractures. J Knee Surg. 2019;33:611–5.PubMed
10.
Zurück zum Zitat Gaunder CL, Zhao Z, Henderson C, McKinney BR, Stahel PF, Zelle BA. Wound complications after open reduction and internal fixation of tibial plateau fractures in the elderly: a multicentre study. Int Orthop. 2019;43:461–5.CrossRef Gaunder CL, Zhao Z, Henderson C, McKinney BR, Stahel PF, Zelle BA. Wound complications after open reduction and internal fixation of tibial plateau fractures in the elderly: a multicentre study. Int Orthop. 2019;43:461–5.CrossRef
11.
Zurück zum Zitat Morris BJ, Unger RZ, Archer KR, Mathis SL, Perdue AM, Obremskey WT. Risk factors of infection after ORIF of bicondylar tibial plateau fractures. J Orthop Trauma. 2013;27:e196–200.CrossRef Morris BJ, Unger RZ, Archer KR, Mathis SL, Perdue AM, Obremskey WT. Risk factors of infection after ORIF of bicondylar tibial plateau fractures. J Orthop Trauma. 2013;27:e196–200.CrossRef
12.
Zurück zum Zitat Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37:691–7.CrossRef Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury. 2006;37:691–7.CrossRef
13.
Zurück zum Zitat Leroux T, Wasserstein D, Henry P, Khoshbin A, Dwyer T, Ogilvie-Harris D, Mahomed N, Veillette C. Rate of and risk factors for reoperations after open reduction and internal fixation of midshaft clavicle fractures: a population-based study in Ontario, Canada. J Bone Jt Surg Am. 2014;96:1119–25.CrossRef Leroux T, Wasserstein D, Henry P, Khoshbin A, Dwyer T, Ogilvie-Harris D, Mahomed N, Veillette C. Rate of and risk factors for reoperations after open reduction and internal fixation of midshaft clavicle fractures: a population-based study in Ontario, Canada. J Bone Jt Surg Am. 2014;96:1119–25.CrossRef
14.
Zurück zum Zitat Vestergaard V, Pedersen AB, Tengberg PT, Troelsen A, Schrøder HM. 20-year trends of distal femoral, patellar, and proximal tibial fractures: a Danish nationwide cohort study of 60,823 patients. Acta Orthop. 2020;91:109–14.CrossRef Vestergaard V, Pedersen AB, Tengberg PT, Troelsen A, Schrøder HM. 20-year trends of distal femoral, patellar, and proximal tibial fractures: a Danish nationwide cohort study of 60,823 patients. Acta Orthop. 2020;91:109–14.CrossRef
15.
Zurück zum Zitat Du Bois M, Szpalski M, Donceel P. A decade’s experience in lumbar spine surgery in Belgium: sickness fund beneficiaries, 2000–2009. Eur Spine J. 2012;21:2693–703.CrossRef Du Bois M, Szpalski M, Donceel P. A decade’s experience in lumbar spine surgery in Belgium: sickness fund beneficiaries, 2000–2009. Eur Spine J. 2012;21:2693–703.CrossRef
16.
Zurück zum Zitat Wasserstein D, Henry P, Paterson JM, Kreder HJ, Jenkinson R. Risk of total knee arthroplasty after operatively treated tibial plateau fracture a matched-population-based cohort study. J Bone Jt Surg Ser A. 2014;96:144–50.CrossRef Wasserstein D, Henry P, Paterson JM, Kreder HJ, Jenkinson R. Risk of total knee arthroplasty after operatively treated tibial plateau fracture a matched-population-based cohort study. J Bone Jt Surg Ser A. 2014;96:144–50.CrossRef
17.
Zurück zum Zitat Hoekstra H, Smeets B, Metsemakers WJ, Spitz AC, Nijs S. Economics of open tibial fractures: the pivotal role of length-of-stay and infection. Health Econ Rev. 2017;7:2.CrossRef Hoekstra H, Smeets B, Metsemakers WJ, Spitz AC, Nijs S. Economics of open tibial fractures: the pivotal role of length-of-stay and infection. Health Econ Rev. 2017;7:2.CrossRef
18.
Zurück zum Zitat Monteban P, van den Berg J, van Hees J, Nijs S, Hoekstra H. The outcome of proximal fifth metatarsal fractures: redefining treatment strategies. Eur J Trauma Emerg Surg. 2018;44:727–34.CrossRef Monteban P, van den Berg J, van Hees J, Nijs S, Hoekstra H. The outcome of proximal fifth metatarsal fractures: redefining treatment strategies. Eur J Trauma Emerg Surg. 2018;44:727–34.CrossRef
19.
Zurück zum Zitat Garrison Kimberly R, Shemilt I, Donell S, Ryder Jonathan J, Mugford M, Harvey I, Song F, Alt V. Bone morphogenetic protein (BMP) for fracture healing in adults. Cochrane Database Syst Rev. 2010;6:6950. Garrison Kimberly R, Shemilt I, Donell S, Ryder Jonathan J, Mugford M, Harvey I, Song F, Alt V. Bone morphogenetic protein (BMP) for fracture healing in adults. Cochrane Database Syst Rev. 2010;6:6950.
Metadaten
Titel
Tibial plateau fractures in Belgium: epidemiology, financial burden and costs curbing strategies
verfasst von
Michiel Herteleer
Celien Van Brandt
Cindy Vandoren
Stefaan Nijs
Harm Hoekstra
Publikationsdatum
23.10.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 5/2022
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-020-01525-8

Weitere Artikel der Ausgabe 5/2022

European Journal of Trauma and Emergency Surgery 5/2022 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.