Infection in the presence of skeletal fixation in the upper extremity.

Infection is infrequent after open fractures of the upper extremity. Treatment begins with prevention through the appropriate use of prophylactic antibiotics, adequate wound debridement, and timely soft-tissue coverage. If infection supervenes, the surgeon must identify the responsible bacteria and administer antibiotics accordingly. Stable fixation is retained. Unstable fixation is removed and skeletal stability restored. Using these principles, infection in the presence of skeletal fixation can be controlled and fracture union achieved.