{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:47:11Z","timestamp":1791402431353,"version":"4.3.3"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,11,5]],"date-time":"2022-11-05T00:00:00Z","timestamp":1667606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1098550"],"award-info":[{"award-number":["APP1098550"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Given the cost differential between surgical and non\u2010surgical management of distal radius fractures, we aimed to evaluate the cost\u2010effectiveness of surgical compared with non\u2010surgical treatment of distal radius fractures in a cohort of older patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This evaluation was conducted alongside the combined randomized and observational study of surgery for fractures of the distal radius in the elderly (CROSSFIRE) trial (ACTRN 12616000969460) which compared surgical (open reduction and internal fixation using volar\u2010locking plate (VLP) fixation) and non\u2010surgical (closed fracture reduction and cast immobilization (CR)) treatment for displaced distal radius fractures in patients \u226560\u2009years. Cost\u2010effectiveness was assessed from the perspective of the public hospital funder. Hospital records from a sub\u2010sample of participants were used to estimate costs. Outcomes were patient\u2010reported wrist pain and function questionnaire (PRWE) scores and quality adjusted life years (QALYs) calculated using the EuroQoL five\u2010dimension five\u2010level tool (EQ\u20105D\u20105L).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 166 participants (81 surgical, 85 non\u2010surgical), costs were obtained for 56 (29 surgical, 27 non\u2010surgical). The mean costs for VLP fixation were Australian dollars (AUD) 6668 (95% CI $4857 to $8479) compared to AUD 3343 (95% CI $1304 to $5381) for CR. The incremental cost\u2010effectiveness ratios (ICER) to achieve a 1\u2010point improvement in the PRWE were AUD 375, AUD 1736 and AUD 1126 at 3, 12 and 24\u2009months for VLP compared with CR. At 12\u2009months, the cost effectiveness was dominated by CR (lower cost and better QoL) whereas at 24\u2009months, the incremental cost per QALY gained by VLP was AUD 1\u2009946\u2009127.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the treatment of distal radius fractures in patients \u226560\u2009years, VLP fixation was not cost\u2010effective compared with CR from the perspective of hospital funders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18134","type":"journal-article","created":{"date-parts":[[2022,11,5]],"date-time":"2022-11-05T09:07:39Z","timestamp":1667639259000},"page":"3311-3318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Surgical plating versus closed reduction for fractures in the distal radius in older patients: a cost\u2010effectiveness analysis from the hospital perspective"],"prefix":"10.1111","volume":"92","author":[{"given":"Martin","family":"Howell","sequence":"first","affiliation":[{"name":"School of Public Health, Faculty of Medicine and Health University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1367-6443","authenticated-orcid":false,"given":"Andrew","family":"Lawson","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre Ingham Institute for Applied Medical Research  Sydney Australia"},{"name":"South Western Sydney Clinical School UNSW  Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Naylor","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre Ingham Institute for Applied Medical Research  Sydney Australia"},{"name":"South Western Sydney Clinical School UNSW  Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Howard","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine and Health University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian A.","family":"Harris","sequence":"additional","affiliation":[{"name":"Whitlam Orthopaedic Research Centre Ingham Institute for Applied Medical Research  Sydney Australia"},{"name":"South Western Sydney Clinical School UNSW  Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2012.02.001"},{"key":"e_1_2_13_3_1","unstructured":"WattsJJ Abimanyi\u2010OchomJ SandersKM.Osteoporosis costing all Australian: a new burden of disease analysis\u20142012 to 2022. 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