Department of Orthopedic Surgery, University of Minnesota.
Twin Cities Orthopedics.
J Pediatr Orthop. 2021 Oct 1;41(9):e750-e754. doi: 10.1097/BPO.0000000000001901.
Controversy exists surrounding antibiotic use in the setting of pediatric supracondylar humerus fractures treated with closed reduction and percutaneous Kirschner wire (K-wire) fixation. While the reported incidence of infection in the literature is low, surgeons frequently administer preoperative antibiotics. The purpose of this study was to retrospectively review preoperative antibiotic use and incidence of infection in children with supracondylar humerus fractures treated with closed reduction and K-wire fixation. It was hypothesized that antibiotic administration will not affect the incidence of infection following this procedure.
We performed a retrospective review of 1053 patients with supracondylar humerus fractures treated with closed reduction and K-wire fixation at 3 institutions between 2006 and 2016. Patient demographics, antibiotic administration and follow-up data were reviewed in 905 patients.
Of 905 patients, 755 patients received preoperative antibiotics and 150 patients did not. The incidence of infection was 2.5% (n=22) in the group that received preoperative antibiotics and 2.0% in the group that did not receive antibiotics with an overall incidence of infection of 2.4%. The difference between groups did not reach significance (P>0.5). The majority of infections were treated with oral antibiotics with or without early pin removal. Four patients, all in the preoperative antibiotic group, required surgical debridement and intravenous antibiotics.
Retrospective review of the incidence of infection in closed reduction and percutaneous pinning of supracondylar humerus fractures found no difference between patients who received preoperative antibiotics and those who did not receive preoperative antibiotics.
Level III-therapeutic.
在接受闭合复位和经皮克氏针（K 针）固定治疗的小儿肱骨髁上骨折中，抗生素的使用存在争议。虽然文献报道的感染发生率较低，但外科医生经常在术前使用抗生素。本研究的目的是回顾性分析接受闭合复位和 K 针固定治疗的肱骨髁上骨折患儿的术前抗生素使用情况和感染发生率。假设抗生素的使用不会影响该手术的感染发生率。
我们对 3 家机构在 2006 年至 2016 年间接受闭合复位和 K 针固定治疗的 1053 例肱骨髁上骨折患者进行了回顾性分析。在 905 例患者中，回顾了患者的人口统计学、抗生素使用和随访数据。
在 905 例患者中，755 例患者接受了术前抗生素治疗，150 例患者未接受抗生素治疗。接受术前抗生素治疗的患者感染发生率为 2.5%（n=22），未接受抗生素治疗的患者感染发生率为 2.0%，总感染发生率为 2.4%。两组之间的差异无统计学意义（P>0.5）。大多数感染采用口服抗生素治疗，或联合或不联合早期针去除。4 例患者，均在术前抗生素组，需要手术清创和静脉抗生素治疗。
回顾性分析闭合复位和经皮克氏针固定治疗肱骨髁上骨折的感染发生率，发现接受术前抗生素治疗和未接受术前抗生素治疗的患者之间无差异。
III 级治疗。
