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Objectives:

Open tibia fractures pose a clinical and economic burden that is disproportionately borne by low-income countries. A randomized trial conducted by our group showed no difference in infection and nonunion comparing 2 treatments: external fixation (EF) and intramedullary nailing (IMN). Secondary outcomes favored IMN. In the absence of clear clinical superiority, we sought to compare costs between EF and IMN.

Design:

Secondary cost analysis.

Setting:

Single institution in Tanzania.

Patients/Participants:

Adult patients with acute diaphyseal open tibia fractures who participated in a previous randomized controlled trial.

Intervention:

SIGN IMN versus monoplanar EF.

Main Outcome Measurements:

Direct costs of initial surgery and hospitalization and subsequent reoperation: implant, instrumentation, medications, disposable supplies, and personnel costs.