Antibiotic prophylaxis in surgery for closed fracture of the hand

Preoperative antibiotic prophylaxis is associated to internal fixation for closed phalangeal and metacarpal fracture, but its effectiveness is not known. In a consecutive series of 119 adult patients undergoing Kirschner-wire fixation for phalangeal or metacarpal fracture, 56.3% (n = 67) received antibiotic prophylaxis and 43.7% (n = 52) did not. The rate of deep surgical site infection was 1.5% (n = 1) in the group with antibiotic prophylaxis and 1.9% (n = 1) in the group without. Minor skin irritation or infection of the pin tract occurred in 13.4% of cases (n = 9) in the group with antibiotic prophylaxis and 9.6% (n = 5) in the group without. Our findings suggest that use of antibiotic prophylaxis could be reduced in the treatment of closed fractures of the hand treated with removable pins. Therapeutic IV (retrospective review).