Discussion
tibial fracture, edema, fracture, amputation, traumatic, pain, fractures, injuries
EDEMA, SECONDARY, COMPLICATIONS
The costs of fractures and orthopaedic surgeries are usually divided into direct and indirect costs, that is, those associated with treatment and those related to costs due to loss of productivity [In a systematic review published in 2021 [In this context, the need to implement protocols in health services that can reduce the length of stay and the possibility of returning to productivity more quickly is emphasized. This study did not evaluate the secondary indirect costs related to the reallocation of family resources, the need to sell assets, and post-surgical rehabilitation treatment. However, the clinical result leads us to highlight the need for economic evaluation trials of these data related to PBM.The treatment of tibial fractures is reported in the literature as a challenge due to complications, delay in resolution, and impact on the affected patient’s life [In this study, PBM was compared with a placebo, that is, an LED device was inserted as an adjuvant in standard hospital procedures, and even though it was an addition, it represented a 35% saving in the cost of general treatment due to the reduction in length of hospital stay [PBMs have been studied and considered effective in controlling pain, edema, and tissue repair A clinical trial with 68 participants with tibial fracture compared the use of laser in the wavelength of 830 nanometers and 26J/cm2 with a placebo. It demonstrated that the PBM group represented a faster resolution of pain and ambulation cases than the control [The results of the randomized clinical trial that evaluated the effects of PBM in treating traumatic soft tissue injuries associated with bone fractures reaffirm the clinical importance of PBM therapy, its efficacy, and safety, with a reduction in the time required for definitive surgery and hospitalization [This scientific data was the first to economically evaluate using PBM as an adjuvant treatment in repairing soft tissue lesions after tibial fracture associated with soft tissue lesions. However, despite all the methodological efforts for clinical and economic analysis, because it is an area still under development in scientific production, it is necessary to increase the number of clinical trials for data composition and more complete and comprehensive economic analysis.In the simulation of cost-effectiveness analysis in this study, the Incremental Cost-Effectiveness Ratio (ICER) matrix could observe a positive scenario for PBM insertion. Regarding the daily average of the BATES-Jensen scale, the experimental group showed higher effectiveness and lower cost; it would be classified as dominant in this economic analysis model. However, it is not yet possible to directly compare the literature with the existing data.One of the limitations of this preliminary analysis is that this study does not provide a cost-utility analysis, considering the quality of life-adjusted life years (QALYs), which is regarded as an economically important aspect [We admit that other factors need to be considered for further cost-effectiveness studies. Economic burdens with amputation, loss of permanent productivity, and other comorbidities can be inserted in future trials.