Non-union is a complication of fracture repair that significantly impacts patient wellbeing and healthcare costs. This study was designed to better understand care pathway and payer cost of non-union following fracture repair.

A retrospective database analysis was conducted in Truven Commercial Claims and Encounters (CCAE). All patients with a femoral (FEM), tibial and/or fibular (T/F) fracture from 2010 to third quarter 2015 were identified. The first date of femoral fracture was used as index date. To be included in the analysis, all patients had at least 2 years of complete medical history. Patients with amputation at time of index were excluded as they were no more at risk of non-union. Patients were categorized based on whether or not they developed non-union in the 5-730 days post-index. For all patients, cost of out and inpatient care was analyzed from time of index to two-years post. Payments were adjusted for inflation to 2016 index. A regression model was built to evaluate cost of non-union.

CONCLUSIONS:

Non-union is a frequent complication following lower leg fracture and is associated with lengthy and costly healthcare utilization.