Direct medical costs of paediatric diaphyseal femoral fracture treatment in a public academic hospital in South Africa.

Background: There is relatively little literature into the cost of treating diaphyseal femur fractures in paediatric population. This study aims to determine the cost of managing paediatric diaphyseal femur fractures in a South African Academic Hospital. Objective and Methods: We conducted a retrospective study using prospectively collected data on paediatric diaphyseal femoral fracture treatment at our public academic hospital over a four-month duration. The study included patients who were between 2 years and 14 years of age and excluded those with femur fractures caused by pathological or atypical factors. The following costs were reviewed: emergency department, inpatient admission, anaesthesia and theatre, allied department, and radiology department. Results: Data from 31 patients (80.6% males) with diaphyseal femoral fractures were included in the study; falls accounted for 64.5% of the injuries. The patients who underwent surgery had a mean hospital stay of 7.4 days (range:3 to 22 days), while the group that did not have surgery had a mean hospital stay of 24.1 days (range:17 to 34 days). The factors that had a greater impact on cost were the duration of the hospital stay, the cost of the implant, and the cost of the theatre. There was no statistically significant variation in the cost of emergency unit services among this group. Conclusion: The data showed that orthopaedic surgeons need to be cognizant of the cost of treating paediatric diaphyseal femoral fractures in the current state of the economy.