Economic analysis of open approach versus conventional methods of zygoma fracture repair.

BACKGROUND As resource allocations in health care are being increasingly guided by cost containment issues, surgical professionals must consider the costs associated with various procedures. The present study identifies the financial costs attributed to the two principal treatment options available for zygoma fractures: the Gillie's method and open reduction and internal fixation (ORIF). METHODS Patients were included if they sustained an isolated zygoma fracture and were treated within 10 days of injury using either ORIF or the Gillie's method. Those who suffered concomitant injuries or required orbital floor exploration and repair were excluded. The end point, which consisted of the total cost required to bring a patient to preinjury facial appearance and function, incorporated the cost of primary treatment and that of any secondary procedures required to correct unfavourable outcomes. RESULTS In total, 45 patients were included: 25 were treated with Gillie's method and 20 were treated with ORIF. The cost associated with the primary treatment of zygoma fractures was found to be higher for ORIF than Gillie's method, amounting to $1,811 and $715, respectively. However, when taking into account potential repair of unsatisfactory results, the final sum totalled $1,930 and $3,725, respectively. This difference was statistically significant. CONCLUSION To the authors' knowledge, this is the first study to objectively examine the cost of the Gillie's method and ORIF in the repair of zygoma fractures. Although the initial cost of ORIF is higher, the final cost of the Gillie's method is greater. Thus, surgeons should not allow higher initial costs to deter them from using more extensive and accurate techniques.