We developed a locking screw plate system for the stabilisation of distal radial fractures, which can be inserted through a standard volar approach and in which the locking mechanism allows early post-operative mobilisation. Forty-nine patients with 50 fractures underwent surgical treatment; 66% were type C fractures. The mean follow-up was 26 months. According to the scores of Gartland and Werley and Green and O'Brien, 92% and 68% respectively had an excellent or good outcome; 46% were radiologically identical to the uninjured side and in 42% the reduction remained unchanged after 2 years. The most frequent complication was rupture of the flexor pollicis longus tendon, which occurred in six cases (12%) at a mean of 10 months after operation. Résumé Nous avons développé un système verrouillable de plaque vissée pour la stabilisation des fractures radiales distales pouvant être inséré à travers une approche palmaire standard et dont le blocage autorise la mobilisation postopératoire précoce. Quarante neuf malades avec 50 fractures ont été opérés; 66% avaient une fracture de type C. Le suivi moyen était 26 mois. D'après les scores de Gartland et Werley et de Green et O'Brien, 92% et 68% avaient, respectivement, un excellent ou bon résultat; 46% étaient radiologiquement identique au côté indemne et dans 42% des cas la réduction est restée inchangée après deux années. La complication la plus fréquente était rupture du tendon long fléchisseur du pouce qui s'est produit dans six cas (12%) à une moyenne de 10 mois après l'opération.

Objectives  Surgical site infection (SSI) following minor surgery contributes to patient morbidity and compromises cosmetic outcomes. The purpose of this study was to determine the incidence of and risk factors for SSI after dermatological surgery in general practice. Methods  A prospective, observational study which assessed infection among 972 patients was conducted in regional north Queensland, Australia. Consecutive patients presenting for minor skin excisions were invited to participate. Wounds were assessed for SSI at the time of removal of sutures. Results  Infection occurred in 85 of the 972 excisions; thus, the overall incidence of infection was 8.7% (95% confidence interval 6.5–11.0). Excisions in the upper (P < 0.001) or lower (P < 0.001) extremities, excisions of basal cell carcinoma (BCC) (P = 0.001) or squamous cell carcinoma (SCC) (P = 0.001), and re‐excision of skin cancer were found to be independent risk factors for wound infection. The length of the excision (P < 0.001) and the patient’s status as an ex‐smoker (P = 0.019) were additional independent risk factors for infection. Diabetes was not found to be an independent risk factor for infection (P = 0.891). Conclusions  Prophylactic antibiotics are probably prescribed excessively or inappropriately for dermatological surgery, and overall we wish to discourage their use. The results of this study may encourage the more judicial use of prophylactic antibiotics by defining high‐risk procedures, such as excisions from the extremities, excision of BCC or SCC, and larger excisions, and patients who are at high risk for infection, such as ex‐smokers.

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