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Nailbed Repairs, Tuft Fractures, And Rate Of Antibiotic Prescriptions
Jessie L. Koljonen, MD, Danielle R. Olla, MD, Lia B. Case, MD, Timothy H. Daugherty, MD, Nicole Z. Sommer, MD.
Southern Illinois University School of Medicine, Springfield, IL, USA.
PURPOSE: Nailbed injuries with tuft fractures are often considered open fractures. Many practitioners prescribe antibiotics following repair, but low infection rates and increasing antibiotic resistance suggest that routine antibiotics may not always be indicated. The goal of our study was to determine current antibiotic prescribing patterns for nailbed injuries and identify complication rates.
METHODS: This was a retrospective chart review of a single institution’s antibiotic prescribing for nailbed injury repairs. Medical records were reviewed for patient demographics, comorbidities, injury characteristics, associated fractures, interventions, and follow-up.
RESULTS: Retrospective data for 314 individuals were analyzed with 334 injured fingers. 73.5% were prescribed antibiotics, and 64.3% had an associated tuft fracture. Of the individuals with associated tuft fractures, 70.6% were prescribed antibiotics. Older age, dirty wounds, and associated tuft fractures were associated with increased odds of being prescribed antibiotics, with each variable independently statistically significantly more likely to be prescribed antibiotics. The postoperative infection rate, regardless of antibiotic status, was 0.79%. The median follow-up duration for those without complication was 12 days, and 20 days for those with complications. There was no statistically significant difference in time to postoperative complication regardless of antibiotic status.
CONCLUSION: Our findings suggest that the routine prescribing of antibiotics in patients with nailbed injuries both with and without associated tuft fractures may be unnecessary, even though tuft fractures are considered open fractures.
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