Research Article
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Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department

Year 2022, Volume: 75 Issue: 3, 433 - 440, 18.10.2022

Abstract

Objectives: Foot and ankle injuries are among the most common injuries in trauma patients. The aim of this study is to evaluate the clinical
characteristics of patients who applied to the emergency department with foot and ankle traumas and the healthcare costs in these patients.

Materials and Methods: Adult patients aged 18 years and over, who applied to the emergency department of a university hospital due to foot and
ankle trauma, were retrospectively analyzed. Patients’ age, gender, trauma mechanism, presence of bone fracture, fracture location, fracture type,
treatment method, and in-hospital cost were examined. Comparisons of variables between the groups were performed with the chi-square test,
Kruskal-Wallis, and the Mann-Whitney test. Statistically, p<0.05 was considered significant.

Results: A total of 523 patients were analyzed in the study, and 55.4% (n=290) of them were male. The most common trauma mechanism in the
patients was ground-level fall (68.8%). It was observed that 16.1% of the patients had bone fractures and the most common fracture location was
the phalanges (36.9%). The average cost per patient was found to be 123.22±505.114 Turkish Liras (TL) and the highest cost was in the patients who
underwent surgical treatment (2172.11±1767,376 TL).

Conclusion: Health care expenses due to foot and ankle traumas constitute an important economic burden considering that the average cost per
patient in this study was 123.22 TL and indirect financial effects. Protective measures should be taken against falls and other injury mechanisms in
order to reduce health care costs related to foot and ankle traumas.

Ethical Statement

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Supporting Institution

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Project Number

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Thanks

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References

  • 1. Probst C, Richter M, Lefering R, et al. Incidence and significance of injuries to the foot and ankle in polytrauma patients--an analysis of the Trauma Registry of DGU. Injury. 2010;41:210-215.
  • 2. Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37:691-697.
  • 3. Banerjee M, Bouillon B, Shafizadeh S, et al. Epidemiology of extremity injuries in multiple trauma patients. Injury. 2013;44:1015-1021.
  • 4. De Boer AS, Schepers T, Panneman MJ, et al. Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986-2010. BMC Musculoskelet Disord. 2014;15:128.
  • 5. Polat O, Güler İ, Tek İ, Öğüt H, Yıldız A. Ayak Bileği Lateral Ligament Yaralanmaları Tedavisi Ve Klinik Deneyimlerimiz. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2002;55:205-210.
  • 6. Fernandez WG, Yard EE, Comstock RD. Epidemiology of lower extremity injuries among U.S. high school athletes. Acad Emerg Med. 2007;14:641-645.
  • 7. DeFroda SF, Gil JA, Owens BD. Epidemiology of lower extremity injuries presenting to the emergency room in the United States: Snow skiing vs. snowboarding. Injury. 2016;47:2283-2287.
  • 8. Lambers K, Ootes D, Ring D. Incidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age. Clin Orthop Relat Res. 2012;470:284-290.
  • 9. Strudwick K, McPhee M, Bell A, et al. Review article: Best practice management of common ankle and foot injuries in the emergency department (part 2 of the musculoskeletal injuries rapid review series). Emerg Med Australas. 2018;30:152-180.
  • 10. Crowley SG, Trofa DP, Vosseller JT, et al. Epidemiology of Foot and Ankle Injuries in National Collegiate Athletic Association Men’s and Women’s Ice Hockey. Orthop J Sports Med. 2019;7:2325967119865908.
  • 11. Shibuya N, Davis ML, Jupiter DC. Epidemiology of foot and ankle fractures in the United States: an analysis of the National Trauma Data Bank (2007 to 2011). J Foot Ankle Surg. 2014;53:606-608.
  • 12. Hunt KJ, Hurwit D, Robell K, et al. Incidence and Epidemiology of Foot and Ankle Injuries in Elite Collegiate Athletes. Am J Sports Med. 2017;45:426 433.
  • 13. Kaplan LD, Jost PW, Honkamp N, et al. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ). 2011;40:40-44. Genç ve ark. Ayak ve Ayak Bileği Travmasında Klinik Özellikler ve Maliyet Ankara Üniversitesi Tıp Fakültesi Mecmuası 2022;75(3):433-440 440
  • 14. Ekinci S, Polat O, Günalp M, et al. The accuracy of ultrasound evaluation in foot and ankle trauma. Am J Emerg Med. 2013;31:1551-1555.
  • 15. Doherty C, Delahunt E, Caulfield B, et al. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44:123-140.
  • 16. Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010;92:2279-2284.
  • 17. Hølmer P, Søndergaard L, Konradsen L, et al. Epidemiology of sprains in the lateral ankle and foot. Foot Ankle Int. 1994;15:72-74.
  • 18. Beckenkamp PR, Lin CC, Macaskill P, et al. Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a systematic review with meta-analysis. Br J Sports Med. 2017;51:504-510.
  • 19. Stiell IG, Greenberg GH, McKnight RD, et al. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992;21:384-390.
  • 20. Cooke MW, Marsh JL, Clark M, et al. Treatment of severe ankle sprain: a pragmatic randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of three types of three types of mechanical ankle support with tubular bandage. The CAST trial. Health Technol Assess. 2009;13:iii, ix-x, 1-121.
  • 21. Drummond MF, Sculpher MJ, Claxton K, et al. Methods for the Economic Evaluation of Health Care Programmes. 4th ed. Oxford University Press; 2015.
  • 22. Noback PC, Freibott CE, Dougherty T, et al. Estimates of Direct and Indirect Costs of Ankle Fractures: A Prospective Analysis. J Bone Joint Surg Am. 2020;102:2166-2173.
  • 23. Hartholt KA, van Beeck EF, Polinder S, et al. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. J Trauma. 2011;71:748-753.
  • 24. Cumps E, Verhagen E, Annemans L, et al. Injury rate and socioeconomic costs resulting from sports injuries in Flanders: data derived from sports insurance statistics 2003. Br J Sports Med. 2008;42:767-772.

Acil Serviste Ayak ve Ayak Bileği Travmalarının Klinik Özelliklerinin ve Maliyetinin Değerlendirilmesi

Year 2022, Volume: 75 Issue: 3, 433 - 440, 18.10.2022

Abstract

Amaç: Ayak ve ayak bileği yaralanmaları travma hastalarında en sık görülen yaralanmalar arasındadır. Bu çalışmanın amacı, acil servise ayak ve ayak
bileği yaralanması nedeniyle başvuran hastaların klinik özelliklerini ve bu hastalardaki sağlık bakım giderlerini incelemektir.

Gereç ve Yöntem: Bir üniversite hastanesi acil servisine ayak ve ayak bileği travması nedeniyle başvuran, 18 yaş ve üzeri erişkin hastalar geriye
dönük olarak incelendi. Hastaların yaşı, cinsiyeti, travma mekanizması, kemik kırığı varlığı, kırık bölgesi, kırık tipi, uygulanan tedavi yöntemi ve
hastane içi maliyeti incelendi. Değişkenlerin gruplar arasında karşılaştırmaları ki-kare testi, Kruskal-Wallis ve Mann-Whitney testleri ile yapıldı.
İstatistiksel olarak p<0,05 değeri anlamlı kabul edildi.

Bulgular: Çalışmada 523 hastanın verileri incelendi ve hastaların %55,4’ü (n=290) erkekti. Hastalarda en sık görülen travma mekanizması düşme
(%68,8) olarak saptandı. Hastaların %16,1’inde kemik kırığı olduğu ve en sık kırık bölgesinin falankslar (%36,9) olduğu görüldü. Hasta başına düşen
ortalama maliyet 123,22±505,114 Türk Lirası (TL) idi ve en yüksek maliyetin cerrahi tedavi uygulanan hastalarda (2172,11±1767,376 TL) olduğu
saptandı.

Sonuç: Bu çalışmada hasta başına ortalama maliyetin 123,22 TL olduğu ve dolaylı mali etkilenmeler de dikkate alındığında ayak ve ayak bileği
travmalarına bağlı sağlık bakım giderlerinin ekonomik açıdan önemli bir yük oluşturduğu söylenebilir. Ayak ve ayak bileği travmas

Ethical Statement

Çalışma için Ankara Üniversitesi Tıp Fakültesi İnsan Araştırmaları Etik Kurulu onayı alınmıştır (tarih: 10.12.2021 karar no: i10-662-21)

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Probst C, Richter M, Lefering R, et al. Incidence and significance of injuries to the foot and ankle in polytrauma patients--an analysis of the Trauma Registry of DGU. Injury. 2010;41:210-215.
  • 2. Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37:691-697.
  • 3. Banerjee M, Bouillon B, Shafizadeh S, et al. Epidemiology of extremity injuries in multiple trauma patients. Injury. 2013;44:1015-1021.
  • 4. De Boer AS, Schepers T, Panneman MJ, et al. Health care consumption and costs due to foot and ankle injuries in the Netherlands, 1986-2010. BMC Musculoskelet Disord. 2014;15:128.
  • 5. Polat O, Güler İ, Tek İ, Öğüt H, Yıldız A. Ayak Bileği Lateral Ligament Yaralanmaları Tedavisi Ve Klinik Deneyimlerimiz. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2002;55:205-210.
  • 6. Fernandez WG, Yard EE, Comstock RD. Epidemiology of lower extremity injuries among U.S. high school athletes. Acad Emerg Med. 2007;14:641-645.
  • 7. DeFroda SF, Gil JA, Owens BD. Epidemiology of lower extremity injuries presenting to the emergency room in the United States: Snow skiing vs. snowboarding. Injury. 2016;47:2283-2287.
  • 8. Lambers K, Ootes D, Ring D. Incidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age. Clin Orthop Relat Res. 2012;470:284-290.
  • 9. Strudwick K, McPhee M, Bell A, et al. Review article: Best practice management of common ankle and foot injuries in the emergency department (part 2 of the musculoskeletal injuries rapid review series). Emerg Med Australas. 2018;30:152-180.
  • 10. Crowley SG, Trofa DP, Vosseller JT, et al. Epidemiology of Foot and Ankle Injuries in National Collegiate Athletic Association Men’s and Women’s Ice Hockey. Orthop J Sports Med. 2019;7:2325967119865908.
  • 11. Shibuya N, Davis ML, Jupiter DC. Epidemiology of foot and ankle fractures in the United States: an analysis of the National Trauma Data Bank (2007 to 2011). J Foot Ankle Surg. 2014;53:606-608.
  • 12. Hunt KJ, Hurwit D, Robell K, et al. Incidence and Epidemiology of Foot and Ankle Injuries in Elite Collegiate Athletes. Am J Sports Med. 2017;45:426 433.
  • 13. Kaplan LD, Jost PW, Honkamp N, et al. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ). 2011;40:40-44. Genç ve ark. Ayak ve Ayak Bileği Travmasında Klinik Özellikler ve Maliyet Ankara Üniversitesi Tıp Fakültesi Mecmuası 2022;75(3):433-440 440
  • 14. Ekinci S, Polat O, Günalp M, et al. The accuracy of ultrasound evaluation in foot and ankle trauma. Am J Emerg Med. 2013;31:1551-1555.
  • 15. Doherty C, Delahunt E, Caulfield B, et al. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med. 2014;44:123-140.
  • 16. Waterman BR, Owens BD, Davey S, et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010;92:2279-2284.
  • 17. Hølmer P, Søndergaard L, Konradsen L, et al. Epidemiology of sprains in the lateral ankle and foot. Foot Ankle Int. 1994;15:72-74.
  • 18. Beckenkamp PR, Lin CC, Macaskill P, et al. Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a systematic review with meta-analysis. Br J Sports Med. 2017;51:504-510.
  • 19. Stiell IG, Greenberg GH, McKnight RD, et al. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992;21:384-390.
  • 20. Cooke MW, Marsh JL, Clark M, et al. Treatment of severe ankle sprain: a pragmatic randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of three types of three types of mechanical ankle support with tubular bandage. The CAST trial. Health Technol Assess. 2009;13:iii, ix-x, 1-121.
  • 21. Drummond MF, Sculpher MJ, Claxton K, et al. Methods for the Economic Evaluation of Health Care Programmes. 4th ed. Oxford University Press; 2015.
  • 22. Noback PC, Freibott CE, Dougherty T, et al. Estimates of Direct and Indirect Costs of Ankle Fractures: A Prospective Analysis. J Bone Joint Surg Am. 2020;102:2166-2173.
  • 23. Hartholt KA, van Beeck EF, Polinder S, et al. Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. J Trauma. 2011;71:748-753.
  • 24. Cumps E, Verhagen E, Annemans L, et al. Injury rate and socioeconomic costs resulting from sports injuries in Flanders: data derived from sports insurance statistics 2003. Br J Sports Med. 2008;42:767-772.
There are 24 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Research Article
Authors

Sinan Genç 0000-0002-0516-1028

Yaşar Çatal 0000-0001-9322-0181

Muhammedcan Şen 0000-0002-5198-1334

Ahmet Burak Oğuz 0000-0001-8796-7529

Ayça Koca 0000-0002-1546-3150

Müge Günalp 0000-0001-8140-6720

Onur Polat 0000-0002-4850-8052

Project Number -
Publication Date October 18, 2022
Published in Issue Year 2022 Volume: 75 Issue: 3

Cite

APA Genç, S., Çatal, Y., Şen, M., … Oğuz, A. B. (2022). Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(3), 433-440. https://doi.org/10.4274/atfm.galenos.2022.59002
AMA Genç S, Çatal Y, Şen M, et al. Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department. Ankara Üniversitesi Tıp Fakültesi Mecmuası. October 2022;75(3):433-440. doi:10.4274/atfm.galenos.2022.59002
Chicago Genç, Sinan, Yaşar Çatal, Muhammedcan Şen, Ahmet Burak Oğuz, Ayça Koca, Müge Günalp, and Onur Polat. “Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75, no. 3 (October 2022): 433-40. https://doi.org/10.4274/atfm.galenos.2022.59002.
EndNote Genç S, Çatal Y, Şen M, Oğuz AB, Koca A, Günalp M, Polat O (October 1, 2022) Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 3 433–440.
IEEE S. Genç, Y. Çatal, M. Şen, A. B. Oğuz, A. Koca, M. Günalp, and O. Polat, “Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 3, pp. 433–440, 2022, doi: 10.4274/atfm.galenos.2022.59002.
ISNAD Genç, Sinan et al. “Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/3 (October2022), 433-440. https://doi.org/10.4274/atfm.galenos.2022.59002.
JAMA Genç S, Çatal Y, Şen M, Oğuz AB, Koca A, Günalp M, Polat O. Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:433–440.
MLA Genç, Sinan et al. “Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 3, 2022, pp. 433-40, doi:10.4274/atfm.galenos.2022.59002.
Vancouver Genç S, Çatal Y, Şen M, Oğuz AB, Koca A, Günalp M, et al. Evaluation of Clinical Features and Cost of Foot and Ankle Traumas in the Emergency Department. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(3):433-40.