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A Double-Blind Clinical Trial of Prophylactic Antibiotics in Hip Fractures
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From the Departments of Orthopaedic Surgery and Surgery, Harvard Medical School at the Massachusetts General Hospital, and the Department of Preventive Medicine, Harvard Medical School, Boston
1973 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1973 Sep 01;55(6):1251-1255
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Antibiotics were given for prophylaxis in hip-fracture patients to a randomized group of patients with hip fractures (417) treated by operation at the Massachusetts General Hospital during three years. After excluding those patients with history of penicillin sensitivity, and those patients already receiving antibiotics at the time of fracture, 348 patients were randomly assigned to a treatment (sodium nafcillin) or control (glucose) group. Either antibiotic or placebo was given before, during, and after operation. The incidence of postoperative wound infection was seven in 145 (4.8 per cent) in the control group, and one in 135 (0.8 per cent) in the treatment group, a statistically significant difference (P = 0.041). The incidence of postoperative wound hematomas was high in each group, possibly because of the routine use of sodium warfarin. Subsequent infection developed in a few of these hematomas, with similar incidence in the control (four in 145) and treatment (six in 135) groups.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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