- Podcast
- 25/11/2022
- UK
Cost-Utility Analysis of Surgical Fixation with Kirschner Wire Versus Casting After Fracture of the Distal Radius
Description
In the November episode of the BJJ podcast hosted by Andrew Duckworth, listeners are greeted with a warm welcome back, highlighting gratitude towards supporters and contributors to The Bone and Joint Journal. The podcast dives into a focused discussion with Professor Matt Costa from Oxford about the paper titled ‘Cost-utility analysis of surgical fixation with Kirschner wire versus casting after fracture of the distal radius’, stemming from the DRAFFT2 Trial.
The conversation begins with an overview of the purpose of the study: comparing the cost-effectiveness between fixation with K-wires and molded casts post-fracture of the distal radius in adults. Costa reminisces about the DRAFFT1 Trial, which compared different fixation methods and led to significant changes in clinical practice in the UK, emphasizing cost-effectiveness and similar clinical outcomes across different methods of fixation.
DRAFFT2 brings a new dimension by investigating whether a molded cast could provide similar results as wire fixation when the fracture can be reduced closed. Key findings indicate that while one in eight patients with a plaster cast may lose their reduction shortly after being treated, those with either method achieve comparable quality-of-life outcomes.
On examining the economic aspect, the podcast notes that the primary analysis follows a National Health Service perspective, considering a broad range of resource use and cost implications. The conclusion drawn from the study suggests that wire fixation, although slightly more costly, does not significantly improve patient outcomes compared to casting, raising questions about its cost-effectiveness.
Overall, Costa and Duckworth emphasize patient perspectives, questioning if patients would prefer a more definitive surgery or would lean towards avoiding operating theatre visits. The episode encapsulates an insightful discussion on balancing clinical efficacy with economic viability and patient preference in healthcare decision-making.