The justification for antibiotic prophylaxis in operative treatment of hand and wrist bone fractures – a review

Introduction. Although there is no clear scientific evidence justifying antibiotic prophylaxis in operative treatment of hand and wrist bone fractures, it is commonly used, mostly due to the concern about possible medicolegal problems caused by bone infection after surgery. Aim. This study’s aim was to review literature on the justification for the use of antibiotic prophylaxis in surgical treatment of hand and wrist fractures. Results. For operative treatment of hand fractures, 3 studies and one systematic review were found. All these articles indicate a lack of scientific evidence to justify the routine administration of antibiotics in these injuries. For operative treatment of distal radial fractures, only 1 study was found suggesting that antibiotic prophylaxis does not affect the risk of infection. Further literature review showed that redundant antibiotic use may be associated with harmful and adverse effects and substantial costs. Conclusion. Current scientific evidence does not support the routine use of antibiotic prophylaxis in the operative treatment of hand and wrist bone fractures. Antibiotic administration in these operations has no effect on decreasing infection rate and, therefore, can be safely avoided.