Locking Versus Nonlocking Implants in Isolated Lower Extremity Fractures: Analysis of Cost and Complications


The purpose of this study was to investigate operative costs and postoperative complication rates in  relation to utilization of locking versus nonlocking implants in isolated, lower limb fractures. Seventyseven patients underwent plate fixation of isolated bicondylar tibial plateau, bimalleolar ankle, and trimalleolar ankle fractures at a large tertiary care center. Fixation with locking versus nonlocking implants was compared to incidence of postsurgical complications. Costs of these implants were directly compared. No significant correlation was found between locking versus nonlocking implants and incidence of complications. However, the cost of fixation with locking implants was significantly greater than nonlocking for all fractures. Utilization of more costly locking implants was not associated with reduced postoperative complications compared with nonlocking implants. More attention must be dedicated toward maximizing cost efficiency, since uniform usage of nonlocking implants has the potential to reduce surgical costs without compromising patient outcomes in isolated lower extremity fractures. (Journal of Surgical Orthopaedic Advances 25(1):49–53, 2016) Key words: isolated lower extremity fractures, locking implants, nonlocking implants

Thomas J. An, BA; Rachel V. Thakore, BS; Sarah E. Greenberg, BA; Vasanth Sathiyakumar, BA; Harrison F. Kay, BS; Michael Gerasimopoulos, MBA; William T. Obremskey, MD, MPH, MMHC; and Manish K. Sethi, MD