ABSTRACT
Wound infection is the disastrous complication after clean orthopaedic surgery. Role of prophylactic single dose parenteral antibiotic is still controversial in prevention of this morbidity. Frequency of wound infection in patients underwent open reduction and internal fixation of long bone clean orthopaedic fracture using single dose antibiotic prophylaxis. case series study. This study was conducted at the Department of Orthopaedic Unit 1, Civil Hospital, Karachi from 11[th] August 2010 to 10[th] February 2011. A total of 231 patients having long bone clean orthopaedic fracture were selected. Patients diagnosed as clean orthopaedic cases and determination of fractures on X-ray with intact skin over fractures were included in the study. Patients with open fracture having co-morbidities already on antibiotics were excluded from the study. Open reduction and internal fixation was carried out using single prophylactic dose of injection cepharadine [2 grams]. Wound infection was assess on 5[th] postoperative day according to Southampton wound grading system. There were 191 males and 40 females with mean age 36.70 years. Out of 231 patients, 213 had no infection while 18 cases had wound infection on 5[th] postoperative day. The use of single dose prophylactic antibiotic prophylaxis is effective in preventing wound infection after management of clean long bones orthop
Subject(s)
Humans , Male , Female , Orthopedics , Wound Infection , Antibiotic Prophylaxis , Fractures, BoneABSTRACT
Fracture of femur in adult patients presents special problems. Orthopaedic surgeons often encounter diaphyseal femur fractures, because these fractures most often result from high - energy trauma, one must have high index of suspicion for complications. Currently reamed interlocking nailing is indicated for most femur fractures because of high rate of union, low rate of complications and advantage of early stabilisation which decreases the morbidity and mortality rate in patients. The objective was to determine the functional outcome of intra-medullary interlocking nailing in diaphyseal fracture of femur in adults in terms of early rehabilitation and fracture healing. This prospective study was carried out from 1.9.2008 to 31.3.2010 in the Department of Orthopaedics, Social Security Teaching Hospital, Lahore. Twenty five patients aged between 20 - 50 years having fracture diaphysis of femur were included. Patients less than 18 years of age, open grade III fractures and pathological fractures were excluded from the study. Routine preoperative investigations were done. Radiological assessment included AP and lateral radiograph of thigh with hip and knee and chest PA/AP view. There were 21 males and 4 females with male to female ratio 5.25:1. The age ranges from 20 - 50 years with mean age of 31.2 years. Majority of the fractures were spiral fractures seen in 9 cases. Comminuted fracture seen in 8 cases, oblique fracture seen in 5 cases and transverse fractures were seen in 3 cases. The results obtained were excellent in 13 patients, good in 9 patients, fair in 2 patients and poor in 1 patient. Mean time of fracture healing was observed 14.3 +/- 1.3 with range of 12 - 16 weeks. The most preferred treatment in the management of fracture diaphysis of femur is intra-medullary interlocking nail especially in skeletally mature patients as regards early rehabilitation and fracture healing