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Do Prophylactic Antibiotics Decrease Risk of Infection in Closed Percutaneous Pinning of Pediatric Hand Fractures?
Christine A Ho1,2,3, Sonia Chaudhry4, Hilton P Gottschalk5
1University of Texas Southwestern Medical Center.
Journal of Pediatric Orthopedics
|July 10, 2026
Summary
Pediatric hand fracture surgery (CRPP) showed a lower infection risk with prophylactic antibiotics. Antibiotics reduced superficial infections from 2.01% to 0.2% in this study.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Infectious Disease Prevention
Background:
- Established infection rates for pediatric hand closed reduction percutaneous pinning (CRPP) are limited.
- Adult hand CRPP infection rates range from 7% to 16%, contrasting with a reported 2% in a small pediatric cohort.
Purpose of the Study:
- To establish baseline infection rates for pediatric hand CRPP.
- To compare infection rates between patients receiving prophylactic antibiotics (ABX) and those not receiving them (NABX).
Main Methods:
- Retrospective analysis of 734 pediatric patients undergoing CRPP for closed finger/hand fractures across 6 institutions.
- Comparison of infection rates between ABX and NABX groups using appropriate statistical tests (t-test, Mann-Whitney, χ2, Fisher exact).
Main Results:
- Overall superficial infection rate was 0.8% (6/734).
- The ABX group had a significantly lower infection rate (0.2%) compared to the NABX group (2.01%) (P<0.05).
- Demographics and medical history were similar; however, surgical preparation, immobilization, and procedural times differed between groups.
Conclusions:
- Pediatric hand CRPP is associated with a higher risk of superficial infection in patients not receiving preoperative prophylactic antibiotics.
- The overall infection rate in this large pediatric cohort was comparable to existing literature, but prophylactic antibiotics demonstrated a significant benefit.
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