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Antibiotics and compound finger fracture
  1. Martin Thomas,
  2. Steve Jones
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL

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    Report by Martin Thomas, Research FellowSearch checked by Steve Jones, Clinical Research Fellow

    Clinical scenario

    A 25 year old man attends the emergency department having trapped his right index finger in a door. He has a compound fracture of the distal phalanx. You wonder whether antibiotics should be given after wound care.

    Three part question

    In [patients with compound finger fractures] does [adding antibiotics] reduce [infection rates]?

    Search strategy

    Medline 1966–01/00 using the OVID interface. ({exp finger injuries OR exp fingers OR finger$.mp OR digit$.mp} AND {exp fractures, open OR open fracture$.mp OR compound fracture$.mp}) LIMIT to human AND english.

    Search outcome

    Altogether 61 papers found of which 59 were irrelevant or of insufficient quality. The remaining two papers are shown in table 1.

    Table 1

    Comments

    The two studies found come to quite different conclusions. The second paper specifies much more rigorous wound management and this may explain the outcome.

    Clinical bottom line

    All compound finger fractures should be rigorously cleaned and debrided. Antibiotics may reduce infection rates even more.

    Report by Martin Thomas, Research FellowSearch checked by Steve Jones, Clinical Research Fellow

    References

    View Abstract

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