Cost-effectiveness of pin-in-fibreglass cast versus Kirschner-Ehmer type I external skeletal fixator in the management of transverse radius-ulna fractures in dogs

Abstract

The cost of medical care is an important issue all over the world. With worsening global economy and the poverty inherent in low earning  economies in the third world countries, economic considerations have always remained a major determinant factor in the choice of treatment. In this study, the cost-effectiveness of pin-in-fibreglass cast fixator (PFCF) was comparatively evaluated against a commercially available fixator  (Kirschner-Ehmer type I external fixator) (KESF) in the management of induced closed transverse mid-shaft radius-ulna fractures in dogs. Four adult (2 males and 2 females) dogs with closed transverse mid-shaft radius-ulna fractures were used for this study. These dogs were randomly assigned to two groups (A and B) with each group made up of two dogs. Radius-ulna fractures were created in all the dogs under injectable anaesthesia as follows: Group A; PFCF, and Group B; KESF. A cost analysis was performed using the duration of operative and post-operative procedures, duration of morbidity period, direct and indirect labour cost, and cost of dog-hour lost during the morbidity period as economic indices. The overall duration of the operative and the entire post-operative procedures were 5.5±0.14 and 22±0.21 hours (1:4.4) for PFCF and KESF (P>0.05) respectively. The morbidity period was 9 and 8 weeks for PFCF and KESF respectively. The average cost of medical care (in 2015 $1 US ≈ N198 Nigerian Naira) was $81.8 and $294 (1:3.6) for PFCF and KESF respectively. The cost benefit analysis based on the economic loss due to dog-hour lost during the morbidity period were $990. 9 and $1103 (1:1.1) for PFCF and KESF respectively. In conclusion, PFCF is faster and easier to perform, and more economical than the KESF technique despite the longer morbidity period associated with it. This is accounted for by the lower cost of fixative and hospital charges.

Keywords: Dog, Cost effectiveness, Pin-in-fiberglass cast, Kirschner-Ehmer external fixative, Radius-ulna, fractures