AIMS & OBJECTIVES: The purpose of this study was to evaluate for cost variation in distal radius fractures (DRFs) treated with a volar locking plate (VLP) and to identify key factors that affect the total construct cost. MATERIALS & METHODS: A retrospective case series was conducted for a single healthcare system. A total of 140 patients with a DRF treated with a VLP from May 2014 to December 2021 were identified. Patients were excluded for polytrauma, open fractures, and skeletal immaturity. RESULTS: Most patients were female (n聽=聽120, 85.7%) and were on average 59聽卤聽13.7 years old. Patients most often injured their dominant hand (n聽=聽75, 53.6%) and presented with an AO/OTA 23C fracture (n聽=聽93, 66.4%). Twenty-two surgeons were included with fellowship training in hand or trauma and orthopaedic or plastic surgery residency. Orthopaedic hand-trained surgeons treated the highest proportion of 23C fractures (69.8%). Ninety patients (64.3%) were treated at a surgery center. The average cost was $1289.67聽卤聽$215.32 (range: $857.83-$2156.95). The most expensive fixation constructs used a variable angle locking screw ($1316.75聽卤聽$264.99) or a multidirectional threaded peg ($1321.67聽卤聽$192.94). Multivariable regression analysis revealed none of the study variables to be significant contributors to construct cost (all p-values >0.27). CONCLUSIONS: Surgically treated DRFs with a VLP demonstrated similar total implant costs regardless of fracture pattern, surgeon specialty, or treatment facility. Contrary to previous literature, VLPs showed minimal cost variation, although some surgeons were able to decrease the overall cost by reducing the number of screws used.
