{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:27:07Z","timestamp":1790868427122,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intramedullary screw fixation is a relatively new technique for fixation of metacarpal and phalangeal fractures. The objective of this study was to compare health care\u2013associated costs and outcomes for intramedullary screw versus Kirschner wire (K-wire) fixation of hand fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of patients undergoing intramedullary screw fixation of hand fractures at a single center during 2016-2019 inclusive was conducted. Health care\u2013associated costs were compared with age-matched and fracture pattern\u2013matched controls who underwent K-wire fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty patients met the study inclusion criteria, incorporating 62 fractures (29 K-wire, 33 intramedullary screw fixation). The median age was 34.6 years (18.0-90.1 years). There was no significant difference in primary operative costs (\u00a31130.4 \u00b1 \u00a3162.7 for K-wire vs \u00a31087.0 \u00b1 \u00a3104.2 for intramedullary screw), outpatient follow-up costs (\u00a3958.7 \u00b1 \u00a3149.4 for K-wire vs \u00a3782.4 \u00b1 \u00a3143.8 for intramedullary screw), or total health care\u2013associated costs (\u00a32089.1 \u00b1 \u00a3209.0 for K-wire vs \u00a31869.4 \u00b1 \u00a3195.3 for intramedullary screw). However, follow-up costs were significantly lower for the uncomplicated intramedullary screw cohort (\u00a3847.1 \u00b1 \u00a3109.1 for K-wire vs \u00a3657.5 \u00b1 \u00a3130.8 for intramedullary screw, P = .05). Subgroup analysis also revealed that overall costs were significantly higher for buried K-wire techniques. Complication rates, time to return to active work, and Disabilities of the Arm, Shoulder, and Hand scores were similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified significantly lower outpatient follow-up costs for uncomplicated intramedullary screw fixation of hand fractures compared with K-wires, along with a trend toward lower overall health care\u2013associated costs. In addition, buried K-wire techniques were also found to carry a significantly higher financial burden. Higher powered prospective studies are required to determine indirect costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447211030690","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T07:36:46Z","timestamp":1627285006000},"page":"456-462","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Cost Comparison of Kirschner Wire Versus Intramedullary Screw Fixation of Metacarpal and Phalangeal Fractures"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4388-1680","authenticated-orcid":false,"given":"Christopher F.","family":"Brewer","sequence":"first","affiliation":[{"name":"Cambridge University Hospitals, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quillian","family":"Young-Sing","sequence":"additional","affiliation":[{"name":"St Andrews Centre for Burns and Plastic Surgery, Broomfield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Sierakowski","sequence":"additional","affiliation":[{"name":"St Andrews Centre for Burns and Plastic Surgery, Broomfield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"bibr1-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.07.023"},{"key":"bibr2-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.09.041"},{"key":"bibr3-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2013.02.017"},{"key":"bibr4-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.11.023"},{"key":"bibr5-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1177\/1558944719836214"},{"key":"bibr6-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1618911"},{"key":"bibr7-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005478"},{"key":"bibr8-15589447211030690","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.05.011"},{"issue":"1","key":"bibr9-15589447211030690","first-page":"67","volume":"64","author":"Nerys W","year":"2020","journal-title":"Occup Med"},{"key":"bibr10-15589447211030690","unstructured":"NHS England. 2019\/20 national tariff. https:\/\/www.england.nhs.uk\/publication\/past-national-tariffs-documents-and-policies\/. 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