Type I Open Fractures Benefit From Immediate Antibiotic Administration But Not Necessarily Immediate Surgery.
Pediatric open fractures are rare, occurring in approximately 2% to 9% of all pediatric fractures. Type I open fractures represent the most common type of open fractures seen in pediatrics and are commonly caused by low-energy mechanisms. The management of these injuries has been primarily dictated by the adult literature. Immediate antibiotic administration, specifically a first generation cephalosporin, has been shown to reduce infection rates. The duration of antibiotic treatment is less clear, but longer courses of antibiotics have not been significantly better than a shorter course. Retrospective case series have shown no difference in infection rates with nonoperative management of type I open fractures. However, concern regarding serious and even life-threatening infection continues to limit the universal adoption of nonoperative treatment protocols. A prospective randomized control trial is underway and will hopefully elucidate which open fractures can be safely managed with prompt antibiotic administration and nonoperative care.
Children's Hospital Los Angeles, Los Angeles, CA.
Jenna
J
Godfrey
J Lee
JL
Pace
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D005597:Fractures, Open / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014946:Wound Infection / Q000209:etiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents