Plating vs. External Fixation for Open Tibia Fractures

Terry Stanton

In presenting his study on the value of damage-control plating, Manish K. Sethi, MD, first framed the economic impetus for evaluating an alternative to external fixation in temporizing open tibia fractures prior to intramedullary (IM) nailing. Noting that Medicare is bundling payments for selected services such as major joint arthroscopy, he said the federal government “intends to expand this system across all of orthopaedics.”

This payment trend, he told his colleagues during the 2014 annual meeting of the Orthopaedic Trauma Association, “puts the onus on us to find cheaper and equally effective solutions in the management of orthopaedic trauma.” Dr. Sethi and his colleagues at Vanderbilt University wanted to see if “in temporizing open tibia fractures with plating, can we reduce cost and maintain quality?”

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