Infection Rates in Open Hand Fractures: Can Surgical Treatment Be Delayed?

The authors hypothesized that the infection rates of open hand fractures treated in a delayed manner would not be higher than those treated immediately. The authors performed a retrospective chart review of patients treated between January 2008 and July 2014 at a Level 1 Trauma Center. Delayed (> 24 hours) versus early (< 24 hours) surgical treatment groups were identified for comparison to determined infection rates. One hundred twenty-nine patients with open hand fractures were compared. Fifty-eight received delayed treatment (> 24 hours), and 71 received immediate surgical treatment (< 24 hours). When adjusted for the severity of injury, there were no significant differences on the rate of infection and rate of reoperation between washout and antibiotics in the emergency department versus immediate surgical treatment. There were no differences in infection rates or reoperation for nonunions with respect to surgical intervention timing. (Journal of Surgical Orthopaedic Advances 33(4):222-224, 2024).