Reoperations of cervical hip fractures: increase risk of wound infection?

A total of 445 cervical hip fractures were operated and followed for 1-5 years. Internal fixation was used in 224 fractures, a total hip replacement was used in 98 fractures and hemiarthroplasty was used in 123 fractures. The failure rate for internal fixation was 63/224 = 28%. The most common complication following total hip replacement and hemiarthroplasty was luxation. A total of 28 of these patients had a total of 55 luxations. Closed reduction was sufficient in 12 patients but 16 patients needed futher surgery. The must common reoperation was a total hip replacement used in 56 cases out of 83 reoperations. A total of 32 (7%) patients had a postoperative superficial or deep infection following either the primary operation or an eventual reoperation. Cultures identified Staphylococcus aureus as the cause in 59% and E. coli in 9.4% of these infections. The total wound infection rate was 5.6% following primary operation in contrast to 8.4% following reoperation (P < 0.05). However the difference was not significant for deep infection alone (2.0% and 2.4%).