A cost analysis of three methods of treating femoral shaft fractures in childrenA comparison of traction in hospital, traction in hospital/home and external fixation

INTRODUCTION: There is no consensus as to which is best treatment of femoral fractures in children. PATIENTS AND METHODS: We performed a cost analysis comparing three treatments of femoral shaft fractures in children aged 3-15 years at 3 hospitals during the same period (1993-2000). The analysis included total medical costs and costs for the care provider and were calculated from the time of injury up to 1 year. RESULTS: At hospital 1, treatment consisted of external fixation and early mobilization. At hospital 2, the treatment was skin or skeletal traction in hospital for 1-2 weeks, followed by home traction. At hospital 3, treatment was skin or skeletal traction in hospital until the fracture healed. RESULTS: The average total costs per patient were EUR 10,000 at hospital 1, EUR 23,000 at hospital 2, and EUR 38,000 at hospital 3. INTERPRETATION: The main factor for determining the cost of treatment was the number of days in hospital, which was lower in children treated with external fixation.