The use of single-use ancillaries does not increase the cost of osteosynthesis in orthopaedic surgery: A case study of plate osteosynthesis for distal radius fractures.

OBJECTIVE: To compare the cost of using single-use instruments (SUIs) and conventional ancillary instruments (CAIs) during osteosynthesis for distal radius fracture (DRF). MATERIAL AND METHODS: We conducted a prospective, monocentric study of ancillary instruments, including a cost minimisation analysis by micro-costing. DRF reduction and postoperative complications were monitored for 3 months. RESULTS: In 103 procedures, the overall cost and operating times were similar between the two groups. The costs of using unit screws, sterilisation, and operating room and pharmacy staff were superior when using SUIs, compared with CAIs. The postoperative outcomes were comparable between groups. CONCLUSION: In our centre, SUI use was associated with logistical advantages, but it was not associated with increased costs. However, the SUI kit should be optimised in the future.

User satisfaction with single-use instruments versus reusable instruments for treating distal radius fractures with locking volar plates.

INTRODUCTION: The adoption of single-use instruments (SUI) in orthopedic and trauma surgery continues at a rapid pace. Economics studies on this topic have come to contradictory conclusions about whether these SUI have a cost advantage. The aims of our study were to (1) compare the satisfaction of operating room staff between SUI and reusable instruments (RUI) in the context of distal radius fracture fixation with locking volar plates; (2) compare the immediate postoperative and medium-term radiological outcomes of patients operated these two types of instrument sets. We hypothesized that users will be more satisfied with SUI in the context of distal radius fracture fixation with locking volar plates. MATERIALS AND METHODS: This was a prospective, single-center study performed between April 2019 and July 2020. The inclusion criteria were patients more than 18 years of age who had a distal radius fracture with indication for fixation with volar locking plate, and whose initial treatment and follow-up were completed in our surgery department. Two groups of patients were created: SUI and RUI. The satisfaction of the surgeons and scrub nurses was determined using a 10-item questionnaire. RESULTS: The analysis was done on 91 procedures for which a satisfaction questionnaire was completed by the primary surgeon and the scrub nurse. The satisfaction scores were always significantly better in the RUI group than in the SUI group (p<0.05). DISCUSSION: This study found that surgeons and scrub nurses in our surgery department liked the RUI better than the SUI. At a time when SUI kits become more popular in orthopedic and trauma surgery, based on cost arguments that still need to be confirmed, taking into account the operating room staff's opinion is an important criterion for improving RUI kits. LEVEL OF EVIDENCE: II.