Poster 181: Dual plating as a Cost-Effective Treatment Option for Operatively Indicated Midshaft Clavicle Fractures

Objectives: Many studies have highlighted lower rates of secondary operations with dual-plating compared to single-plating. Despite higher upfront costs associated the construct, observed reduction in single-plating may make it a more cost- effective treatment option. The objective this study was assess cost-effectiveness dual-plate fixation single-plate patients operatively indicated displaced midshaft clavicle fractures. We hypothesized would be cost-effective surgical option than single-plating, given its postoperative complications. Methods: developed decision tree model occurrence complications (hardware issues, wound healing deep infection, non-union, and symptomatic hardware) surgeries. Complication-specific risk estimates were summarized for both plating techniques. time horizon two years, analysis conducted from healthcare payer’s perspective. included direct medical costs, while benefits measured quality-adjusted life-years (QALYs). assumed that $300 expensive upfront. probabilistic one-way sensitivity analyses. Results: predicted reoperation 6% arm 14% arm. In base case analysis, increased QALYs by 0.007 $70 per patient yielding an incremental ratio (ICER) $10,600 QALY gained. demonstrated dual is driven cost index surgery, hardware single- dual- plating. At willingness pay threshold $100,000 gained, 92% simulations suggested (Figure 1). Conclusions: When indicated, operative management fractures initial appears offset added via reoperations improved quality life.