Objective: The purpose of this study was to evaluate the type and the dosage regimer the antibiotics administered prophylactically or curatively in six orthopaedic departments of «KAT» hospital.

Material-Method: Our study group consisted of 1231 patients who were hospitalized between September and November 2003. 1002 patients were treated surgically whilst 229 patients were managed conservatively. Among the patients who were operated 270 underwent THR or TKR, 306 patients were operated for NOF fracture, 195 patients were admitted because of long-bone fractures, 30 patients were operated for fracture or chronic deformity of the hand or the foot, 26 patients for open fractures, 52 patients underwent spine surgery and finally 53 patients were admitted for metal work removal.

Results: All patients were given antibiotics as prophylaxis for a period of 1–7 days 8 patients received antibiotics based on the cultures whilst 113 patients received empiric chemotherapy for some kind of infection. The microbiology lab recorded the microflora in every department and the percentage of resistance of the most important pathogens. Those were: 47% Gram(+) (45% staphylococcus) and 53% Gram(−). Of the identified staphylococci 44% were MR. MRSA-CNS was detected to be completely resistant to b-lactams and at a percentage up to 80% to amynoglycosides. The percentage of resistance of Pseudomonas was 55% to quinolones, 48% to aminoglycosides and 90% to b-lactams. We did notice that the use of the antibiotics was not based on a specific antibiotic policy and in a high percentage; the empirical use of chemotherapy was not documented on the laboratory data.

Conclusion: Taking into consideration the modern scientific data regarding the antibiotic treatment; the rational use of antibiotics in clinical practice requires the implementation of policies, the continuous education of the doctors as well as the intervention for proper prescriptions.

Aims: Demonstration of our results from treating displaced femoral neck fractures with a new method of closed reduction and internal þxation. Methods: Between 1995 and 1999 we treated 37 patients (21 female and 16 male) with displaced subcapital femoral fractures in the age group between 65 and 70 years. The selection of the appropriate treatment was according to our treatment algorithm based on the age, the displacement of the fracture, the general physical condition, the bone density and the functional demands of the patient. We performed closed reduction using an alternative method. The patient is placed on the traction table without traction of the injured limb. We apply traction on the abducted (> 45¡) healthy limb until the pelvis is mobilized. Finally, a radiological check is performed to decide whether we should modify the traction. This method is also used in other age groups. In 1 case closed reduction was not successful and an open reduction was performed. As a method of internal þxation we used 3 cannulated hip screws. Follow-up of the patients exceeded the period of 2 years. Results: The average Harris Hip Score at 2 years was 76. There were 3 cases of avascular necrosis and 2 cases of non-union of the fracture. In all these 5 patients we performed a conversion to total hip arthroplasty. Conclusions: Although displaced subcapital femoral fractures still remain the unsolved fractures, especially in ages between 65 and 70 years, proper selection of patients and satisfactory reduction of the fracture are the most important factors for a successful internal þxation of the fracture. The proposed alternative method of closed reduction leads to favorable results, comparable to the classical methods of closed reduction.