Single-dose antibiotic prophylaxis in osteosynthesis for hip fractures - Aclinical multicentre study in Finland

Background and Aims: The use of antibiotic prophylaxis in open reduction an d osteosynthesis of closed hip fractures is still controversial. The aim of this study was to demonstrate the effect of antibiotic prophylaxis in oste osynthesis of these fractures. Material and Methods: A total of 224 patients operated on between November 1994 and February 1998 in six hospitals by internal fixation for a fresh hi p fracture were prospectively and randomly allocated to either a ceftriaxon e antibiotic prophylaxis or no prophylaxis group and followed for one year. Results: Within 6 weeks after the operation, 2.6 % wound infections were re corded 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 sens itive to ceftriaxone). There were no statistically significant differences between the infection rates in both groups. However, when analyzing all com plications recorded within 6 weeks, significantly more complications were f ound in the control group (p < 0.01). In the multivariate analysis the most important factor predicting postoperative complications was the lack of an tibiotic prophylaxis. Conclusion: In this study the antibiotic prophylaxis group had significantl y less postoperative complications than the control group within 6 weeks af ter the operation.