A Comparative Study of Ulnar Shortening Osteotomy By the Freehand Technique Versus the Rayhack Technique

Abstract

Dr. T.M. Sunil, and the Group from the Louisville Kleinert Center, have produced an interesting article regarding the comparative study of ulnar shortening osteotomy by the “Free-Hand” technique versus the Rayhack technique. This article can serve as a model for other analyses regarding comparative techniques on similar patients.A factor that was not addressed in this article, and which should be included into the thinking of modern surgeons, involves the required cost for applying problem-specific technology to operations that can also be done “Free Hand.”The rental cost for Rayhack specialized equipment for ulnar shortening osteotomy is about $650. The profit margin per case, in the San Diego Outpatient Surgical Center, is about half that amount. The authors have shown that there is no statistical difference between performing the operation “Free Hand” or with the specialized equipment. Simple multiplication of 52 patients, by $650, shows that $33,800 has been wasted in performing this operation with specialized equipment. There is no evidence that specialized equipment provides any increased “Bang for the Buck.”This economic lesson should be learned for every device for innovative technology that becomes available, since budget requirements force us to choose from those technologies, which are truly significant in producing improved outcomes versus those technologies that are “expensive toys.” Dr. T.M. Sunil, and the Group from the Louisville Kleinert Center, have produced an interesting article regarding the comparative study of ulnar shortening osteotomy by the “Free-Hand” technique versus the Rayhack technique. This article can serve as a model for other analyses regarding comparative techniques on similar patients. A factor that was not addressed in this article, and which should be included into the thinking of modern surgeons, involves the required cost for applying problem-specific technology to operations that can also be done “Free Hand.” The rental cost for Rayhack specialized equipment for ulnar shortening osteotomy is about $650. The profit margin per case, in the San Diego Outpatient Surgical Center, is about half that amount. The authors have shown that there is no statistical difference between performing the operation “Free Hand” or with the specialized equipment. Simple multiplication of 52 patients, by $650, shows that $33,800 has been wasted in performing this operation with specialized equipment. There is no evidence that specialized equipment provides any increased “Bang for the Buck.” This economic lesson should be learned for every device for innovative technology that becomes available, since budget requirements force us to choose from those technologies, which are truly significant in producing improved outcomes versus those technologies that are “expensive toys.” In ReplyJournal of Hand SurgeryVol. 31Issue 8PreviewWe thank Dr. Braun for his comments regarding our article titled “A Comparative Study of Ulnar Shortening Osteotomy By the Freehand Technique versus the Rayhack Technique.” We have conducted a cost analysis of the two techniques and found the following facts based on our hospital billing records. Full-Text PDF