Antibiotic Prophylaxis for Distal Interphalangeal Joint Arthrodesis

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Hand Surgery

Background:

• Antibiotic prophylaxis is not indicated for short, elective soft-tissue hand procedures.
• Consensus is lacking regarding antibiotic use in bony hand procedures involving implants.
• Previous studies on distal interphalangeal (DIP) joint arthrodesis did not specifically analyze infection rates based on antibiotic prophylaxis.

Purpose of the Study:

• To determine if antibiotic prophylaxis impacts infection rates in clean, elective DIP joint arthrodesis.
• To analyze postoperative infection rates in patients undergoing DIP joint arthrodesis with intramedullary screws.
• To provide evidence-based recommendations for antibiotic use in this specific surgical procedure.

Main Methods:

• Retrospective review of clean, elective DIP arthrodesis cases from September 2018 to September 2021.
• Inclusion criteria: patients aged 18+, undergoing elective DIP arthrodesis for osteoarthritis or deformity, using an intramedullary headless compression screw.
• Data collected on postoperative infection rates and required treatments, analyzed using Fisher exact test.

Main Results:

• 37 patients were included: 20 without antibiotic prophylaxis and 17 with prophylaxis.
• Five infections occurred in the non-prophylaxis group; zero infections occurred in the prophylaxis group.
• A statistically significant difference in infection rates was observed (P < 0.05), with no significant difference related to smoking or diabetes status.

Conclusions:

• Antibiotic prophylaxis should be administered for clean, elective DIP joint arthrodesis when using an intramedullary screw.
• Prophylactic antibiotics appear to reduce the risk of postoperative infection in this procedure.
• Further research may explore optimal antibiotic regimens for DIP joint arthrodesis.