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Cost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius : analysis from the DRAFFT trial . We present an economic evaluation using data from the Distal Radius Acute Fracture Fixation Trial ( DRAFFT ) to compare the relative cost effectiveness of percutaneous Kirschner wire ( K-wire ) fixation and volar locking-plate fixation for patients with dorsally-displaced fractures of the distal radius . The cost effectiveness analysis ( cost per quality-adjusted life year ; QALY ) was derived from a multi-centre , two-arm , parallel group , assessor-blind , randomised controlled trial which took place in 18 trauma centres in the United Kingdom . Data from 460 patients were available for analysis , which includes both a National Health Service cost perspective including costs of surgery , implants and healthcare resource use over a 12-month period after surgery , and a societal perspective , which includes the cost of time off work and the need for additional private care . There was only a small difference in QALYs gained for patients treated with locking-plate fixation over those treated with K-wires . At a mean additional cost of £714 ( 95 % confidence interval 588 to 865 ) per patient , locking-plate fixation presented an incremental cost effectiveness ratio ( ICER ) of £89,322 per QALY within the first 12 months of treatment . Sensitivity analyses were undertaken to assess the ICER of locking-plate fixation compared with K-wires . These were greater than £30,000 . Compared with locking-plate fixation , K-wire fixation is a 'cost saving ' intervention , with similar health benefits .
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Intervention_Physical
treatment with percutaneous Kirschner wires versus volar locking plate
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Intervention_Surgical
percutaneous Kirschner wire ( K-wire ) fixation
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Intervention_Physical
and
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Intervention_Surgical
volar locking-plate fixation
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Intervention_Surgical
locking-plate fixation
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Intervention_Surgical
K-wires .
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Outcome_Other
Cost effectiveness of treatment with percutaneous Kirschner wires
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Outcome_Other
( cost per quality-adjusted life year ; QALY )
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Outcome_Other
costs of surgery , implants
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Outcome_Other
healthcare resource use
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Outcome_Other
cost of time off work
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Outcome_Other
additional private care .
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Outcome_Other
QALYs
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Outcome_Other
an incremental cost effectiveness ratio ( ICER )
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Outcome_Other
the ICER
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Participant_Age
adult
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Participant_Condition
dorsally-displaced fractures of the distal radius
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Participant_Condition
trauma
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Participant_Sample-size
460