Single-dose antibiotic prophylaxis in osteosynthesis for hip fractures. A clinical multicentre study in Finland.
OBJECTIVE
The use of antibiotic prophylaxis in open reduction and osteosynthesis of closed hip fractures is still controversial. The aim of this study was to demonstrate the effect of antibiotic prophylaxis in osteosynthesis of these fractures.


METHODS
A total of 224 patients operated on between November 1994 and February 1998 in six hospitals by internal fixation for a fresh hip fracture were prospectively and randomly allocated to either a ceftriaxone antibiotic prophylaxis or no prophylaxis group and followed for one year.


RESULTS
Within 6 weeks after the operation, 2.6% wound infections were recorded in the antibiotic group and 4.7% in the control group. Two (1.9%) of the five infections in the control group were deep infections (both sensitive to ceftriaxone). There were no statistically significant differences between the infection rates in both groups. However, when analyzing all complications recorded within 6 weeks, significantly more complications were found in the control group (p < 0.01). In the multivariate analysis the most important factor predicting postoperative complications was the lack of antibiotic prophylaxis.


CONCLUSIONS
In this study the antibiotic prophylaxis group had significantly less postoperative complications than the control group within 6 weeks after the operation.
Lüthje
P
P
Department of Surgery, Kuusankoski Regional Hospital, Finland.
Nurmi
I
I
Aho
H
H
Honkanen
P
P
Jokipii
P
P
Kataja
M
M
Kytõmaa
J
J
Nirhamo
J
J
Pekkanen
A
A
Rimpiläinen
J
J
Sihvonen
R
R
Sinisaari
I
I
Tulikoura
I
I
Valtonen
V
V
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005387:Finland; D005593:Fracture Fixation, Internal / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing
D002511:Cephalosporins; D002443:Ceftriaxone