Exploring the incidence of infection in children undergoing open reduction for supracondylar elbow fractures without perioperative prophylactic antibiotics.

BACKGROUND

Elbow fractures are among the most common types of fractures in children; an incision is inevitable when open surgery is performed. Prophylactic antibiotics was widely used in paediatric elbow fractures. This study is to investigate factors associated with postoperative infection in children undergoing open reduction and internal fixation with percutaneous pin fixation of supracondylar humeral fractures (SHFs). All patients did not receive prophylactic antibiotics during perioperative period.

METHODS

The clinical data of children with SHF who underwent open reduction and percutaneous pin fixation at our hospital between January 2020 and September 2021 were retrospectively analysed. All patients were divided into no infection (n = 660) and infection (n = 17) groups. Age, sex, duration of surgery, and infection sites were analysed.

RESULTS

Open reduction and percutaneous pin fixation were performed in 677 patients with SHFs. The frequency of infection was 2.51% (n = 17). The results of the chi-square test showed that the frequency of infection was significantly related to age (OR = 0.305, 95% CI; 0.106-0.876, p = 0.020) and operation time (OR = 3.731, 95% CI: 1.412-9.859, p = 0.012), but not to sex (OR = 2.440, 95% CI: 0.787-7.561, p = 0.111) or postoperative hospital stay (OR = 1.887, 95% CI: 0.536-6.639, p = 0.464).

CONCLUSION

Infection is a rare complication of SHF. Children under 5 years of age with a duration of surgery above 1 h have higher infection rates. Wound and pin care should be strengthened to reduce the risk of postoperative infection.

LEVEL OF EVIDENCE: III.