title: Utility of Postoperative Antibiotics After Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures.
abstract: BACKGROUND
  Pediatric supracondylar humerus fractures are common injuries that are often treated surgically with closed reduction and percutaneous pinning. Although surgical-site infections are rare, postoperative antibiotics are frequently administered without evidence or guidelines for their use. With the increasing prevalence of antibiotic-resistant organisms and heightened focus on health care costs, appropriate and evidence-based use of antibiotics is needed. We hypothesized that postoperative antibiotic administration would not decrease the rate of surgical-site infection.
  
  
  METHODS
  A billing query identified 951 patients with operatively treated supracondylar humerus fractures at our institution over a 15-year period. Records were reviewed for demographic data, perioperative antibiotic use, and the presence of surgical-site infection. Exclusion criteria were open fractures, open reduction, pathologic fractures, metabolic bone disease, the presence of other injuries that required operative treatment, and follow-up <2 weeks after pin removal. χ and Fisher exact test were used to compare antibiotic use to the incidence of surgical-site infection.
  
  
  RESULTS
  Six hundred eighteen patients met our inclusion criteria. Two hundred thirty-eight patients (38.5%) received postoperative antibiotics. Eleven surgical-site infections were identified for an overall rate of 1.8%. The use of postoperative antibiotics was not associated with a lower rate of surgical-site infection (P=0.883). Patients with a type III fracture (P<0.001), diminished preoperative vascular (P=0.001) and neurological status (P=0.019), and postoperative hospital admission (P<0.001) were significantly more likely to receive postoperative antibiotics.
  
  
  CONCLUSIONS
  Administration of postoperative antibiotics after closed reduction and percutaneous pinning of pediatric supracondylar humerus fractures does not decrease the rate of surgical-site infection.
  
  
  METHODS
  Level III-therapeutic.
authors.affiliation: Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.
authors.forename: Nicholas O
authors.initials: NO
authors.lastname: Schroeder
authors.forename: Mark A
authors.initials: MA
authors.lastname: Seeley
authors.forename: Arun
authors.initials: A
authors.lastname: Hariharan
authors.forename: Frances A
authors.initials: FA
authors.lastname: Farley
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Caird
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000188:drug therapy / Q000601:surgery*; D015994:Incidence; D007223:Infant; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents