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. 2023 Jan;33(1):119-124.
doi: 10.1007/s00590-021-03169-9. Epub 2021 Nov 24.

The reuse of circular external fixator components: an assessment of safety and potential savings

Kudzai Chironga  1 , Stefan Swanepoel  2 , Roopam Dey  2 , Simon Matthew Graham  2   3   4 , Michael Held  2 , Maritz Laubscher  2
Affiliations

The reuse of circular external fixator components: an assessment of safety and potential savings

Kudzai Chironga et al. Eur J Orthop Surg Traumatol. 2023 Jan.

Abstract

Purpose: Cost-saving strategies are important, especially in a resource-constrained environment. One such strategy well supported in the literature is the reuse of temporary monolateral external fixator components, a strategy we utilize at our institution. The aim of the study was to determine the safety and cost saving associated with the reuse of definitive circular external fixator components in a resource-constrained environment.

Method: We performed a retrospective review of all adult patients who were treated with either new or reused circular external fixators from a single manufacturer between January and December 2017. Reused circular external fixator components, excluding half pins and wires, were subjected to an in-house reprocessing protocol. Cost savings were calculated as the difference between the price of a completely new frame and the amount invoiced for new components only in a reused frame.

Results: Thirty-three patients were included in the study with an average age of 31.9 years. The mean duration of treatment with a circular external fixator was 5.8 months. No mechanical failure events were recorded during the study period. Our institution saved approximately 52% (R717 503.89) and 63% (R136 568.19) of expected total cost for hexapod and Ilizarov frames, respectively.

Conclusion: The strategy of reusing circular external fixator components is unconventional, and this study was conducted to evaluate the safety and potential savings in a resource-constrained environment. We demonstrated this practice to be reasonably safe and to result in significant cost savings which might be relevant in low-and-middle-income countries.

Keywords: Circular external fixator; Cost savings; Low-middle income countries (LMICs); Reprocessing; Reuse; Safety.

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