Failure after proximal humeral fracture osteosynthesis: a one year analysis of hospital-related healthcare cost

Int Orthop. 2020 Jun;44(6):1217-1221. doi: 10.1007/s00264-020-04577-y. Epub 2020 Apr 28.


Purpose: The issue of rising healthcare costs and limited resources is a topic of worldwide discussion over the last several decades. We hypothesized that failure of proximal humeral fracture osteosynthesis is presumed to be an important determinant in healthcare resources and related costs. The aim of this study was to calculate the total hospital-related healthcare cost of proximal humeral fracture osteosynthesis over one year focusing on failure.

Methods: A total of 121 patients with a proximal humeral fracture treated by angular stable osteosynthesis were included in this retrospective study. All hospital-related healthcare costs were investigated. Five main hospital-related cost categories were defined: hospitalization cost, honoraria, day care admission, materials, and pharmaceuticals.

Results: A total healthcare cost of € 1,139,448 was calculated for the whole patient group. Twelve patients needed revision surgery due to complications or fixation-related failure. This failure rate alone costed € 190,809 of the healthcare resources. In other words, failure after proximal humeral fracture osteosynthesis costed 17% of the total healthcare expenditure inone year.

Conclusion: This study demonstrates that a high amount of hospital-related healthcare resources is spent because of failure after proximal humeral fracture osteosynthesis. Further research is necessary and should investigate on how to prevent failure. This is not only in the patient's interest, but it is also of great importance for maintaining a healthy healthcare system.

Keywords: Cost analysis; Failure; Healthcare cost; Osteosynthesis; Proximal humeral fracture.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fracture Fixation, Internal
  • Health Care Costs / statistics & numerical data*
  • Hospital Costs
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • Reoperation
  • Retrospective Studies
  • Shoulder Fractures / economics
  • Shoulder Fractures / surgery
  • Shoulder Fractures / therapy*