Cost of orthopaedic injuries sustained during unsanctioned crossings of the U.S.-Mexico border treated at a single level 1 trauma center

Abstract

Objectives: The purpose of this study is to report the incidence and patterns of injuries, surgical interventions performed, and healthcare costs associated with unlawful border crossings. Design: Retrospective Review Setting: Level 1 Trauma center on US-Mexico Border Main outcome measurement: Demographic and treatment data Results and conclusions: 111 patients were identified with an average age of 32 ± 12 years (range 6-60), and 56% were males. Monthly frequency of admissions was 0.75 in 2017, 1.33 in 2018, and 7.1 in 2019 (p<0.001). Median length of stay was 4 days (interquartile range 2-8). There was a total of 178 orthopaedic injuries (24 upper extremity, 123 lower extremity, 10 acetabular and pelvic ring, 21 spine). Pilon fractures were the most common injury pattern noted (N=33, 19%). Injuries resulted in 146 operative events, 231 procedures, 344 hours of operative room time, and 711 hospital days. 98 patients (88%) received definitive fixation, 13 (12%) had further surgery recommended without ability to follow-up. 92% of patients had no outpatient follow up. Total estimated cost of trauma utilization, diagnostic imaging, operating room utilization, implant costs, inpatient services, and Department of Homeland Security agent supervision was nearly $13.5M over the three-year study period. Injuries associated with unlawful border crossings are complex, costly, and challenging to treat. This is the first study that attempts to quantify the rates of orthopaedic-related hospital admissions, costs, types of injuries sustained, and orthopaedic surgeries being performed on this patient population. Level of Evidence: IVKeywords: Trauma, Pilon, Plateau, Border (J Ortho Business 2022; Volume 2, Issue 3:pages 5-11)