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- Talk
- 15/09/2021
- Canada
Open Reduction Internal Fixation (ORIF) vs Distal Femoral Replacement (DFR) for Treatment of AO 33C Fractures in the Elderly: A Review of Functional Outcomes and Cost Analysis
Description
In this presentation, Andrew Caines, a third-year orthopedic surgery resident at the University of Ottawa, discusses his research paper titled "Opium Reduction Internal Fixation versus Distal Femur Replacement for the Management of Elderly Distal Femur Fractures and Analysis Of Outcomes and Cost." Caines highlights the increasing incidence of distal femur fractures, particularly among the elderly due to low-energy traumas, and the impending rise in these cases as the population ages. He outlines the challenges associated with their management, including high non-union and re-operation rates, which lead to poor functional outcomes and increased mortality.
The study compares the surgical techniques of distal femur replacement and open reduction/internal fixation (ORIF), evaluating both outcomes and financial costs. Caines provides details on the methodology, patient demographics, and statistical analyses used in the study, noting a retrospective cohort design involving nearly 6,000 cases. The final analysis included 12 distal femur replacements and 27 ORIF cases. Caines discusses various outcomes, emphasizing the potential advantage of distal femur replacement in terms of mobilization rates, although many findings did not achieve statistical significance.
Cost analysis revealed that while the index procedure for distal femur replacement was more expensive, the total costs, including re-operations, did not significantly differ between the two groups. He also discusses the implications of the length of hospital stay and emphasizes the study's limitations, including potential biases and the nature of the retrospective analysis. Caines concludes by suggesting the need for prospective trials that could further explore effective treatments for geriatric distal femur fractures, opening the floor for questions from the audience.