External Fixation Characteristics Drive Cost of Care for High-Energy Tibial Plateau Fractures

OBJECTIVE To determine the total cost for a 30-day episode of care for high-energy tibial plateau fractures and the aspects of care associated with total cost. DESIGN Time driven activity-based costing analysis. SETTING One Level I adult trauma center. PATIENTS 121 patients with isolated, bicondylar tibial plateau fractures undergoing staged treatment were reviewed. PRIMARY OUTCOME Total cost. RESULTS A total of 85 patients were included, and most sustained Schatzker VI fractures (n = 66, 77%). All patients were treated with biplanar external fixation prior to definitive fixation. A total of 26 patients (31%) were discharged to skilled nursing facilities, and 37 patients (43%) were not discharged between procedures. Total cost for a 30-day episode of care was $22,113 ± 4056. External fixation components ($5,952, 26.9%), length of hospital stay ($5,606, 25.4%), discharge to SNF ($3,061, 13.8%), and definitive fixation implants ($2,968, 13.4%) contributed to total cost. The following were associated with total cost: Patient discharged to SNF (p