Abstract / Summary
Abstract Background Distal radius fractures are among the most common surgically treated upper-extremity fractures, and volar locking plate fixation is the predominant operative technique. Although perioperative antibiotic prophylaxis is widely used in orthopaedic surgery, procedure-specific evidence for closed distal radius fractures remains limited. Contemporary data regarding postoperative infection rates and antibiotic prophylaxis practice following volar locking plate fixation are scarce. The aim of this study was to describe postoperative infection rates following volar locking plate fixation of closed distal radius fractures and to report contemporary patterns of perioperative antibiotic prophylaxis use in routine clinical practice. Methods This retrospective cohort study included consecutive adult patients undergoing volar locking plate fixation for closed distal radius fractures at a single center between January 2022 and December 2024. Patients were grouped according to receipt of perioperative antibiotic prophylaxis, reflecting routine clinical practice rather than predefined treatment allocation. The primary outcome was postoperative surgical site infection within one year of surgery. Secondary analyses described antibiotic prophylaxis use and patient, surgical, and surgeon-related characteristics. Results A total of 474 consecutive patients were included, of whom 237 received perioperative antibiotic prophylaxis and 237 did not. One postoperative surgical site infection occurred, corresponding to an overall infection rate of 0.2% (95% confidence interval [CI] 0.0–1.2). The infection occurred in a patient who did not receive antibiotic prophylaxis, was superficial, and resolved following treatment with oral antibiotics. No deep infections were observed. Substantial variation in prophylaxis use was observed among surgeons despite uniformly low infection rates across the cohort. Conclusions Postoperative infection following volar locking plate fixation of closed distal radius fractures was rare in this contemporary cohort. The findings provide descriptive data on postoperative infection rates and perioperative antibiotic prophylaxis practice in routine clinical care. Although the study was not powered to evaluate the effectiveness of antibiotic prophylaxis, the observed low infection burden may help inform future research on infection prevention and antibiotic stewardship in distal radius fracture surgery. Level of Evidence III. Clinical trial number Not applicable