Tibial Plateau Fractures Complicated by Compartment Syndrome are Associated with a Three Times Higher Cost of Care.

Abstract

To determine the impact of acute compartment syndrome (ACS) and identify cost-drivers of 1-year total treatment costs for operative tibial plateau fractures. Retrospective review. Level 1 Trauma Center. 337 patients with tibial plateau fractures, 24 of which were complicated by ACS. The primary outcome was total treatment cost over the first year for operatively treated tibial plateau fractures. The secondary objective was to use regression analysis to identify significant cost drivers. The diagnosis of ACS was associated with 2.85 times higher in total treatment cost (p < 0.001). Acute compartment syndrome demonstrated increased total treatment cost when controlling for polytrauma (p < 0.001) and post-operative infection (p < 0.001). Regression analysis identified 5 variables significantly associated with total cost of care: Body Mass Index, Injury Severity Score, ACS, Staged External Fixation, and Locking Fixation (p < 0.001; R2 = 0.57). The diagnosis of ACS had the largest impact on total cost with a 3.5x greater impact on cost compared to the next highest variable, staged external-fixation. Tibial plateau fractures complicated by ACS are associated with 2.85 times higher treatment costs over a 1-year period. There were 5 significant variables identified by regression analysis with ACS having the highest impact on total treatment. Together, these 5 factors account for 57% of treatment cost variability. Economic Level III. See Instructions for Authors for a complete description of levels of evidence.