[Fracture-related infections in traumatology : Current standards and new developments in diagnostics and treatment]

Orthopade. 2020 Aug;49(8):702-709. doi: 10.1007/s00132-020-03948-y.
[Article in German]

Abstract

Background: The high demands that fracture-related infections put on patients, physicians and the healthcare system have led to the establishment of a international group of experts called the Fracture-Related Infection (FRI) Consensus Group, whose aim is to develop evidence-based treatment recommendations.

Diagnosis: Fracture-related infections are classified according to the time of occurrence, extent and treatment options. The diagnostic algorithm distinguishes between confirmatory and suggestive diagnostic criteria. If there are indications of an infection, tissue biopsy with microbiological and histological workup is recommended to confirm the diagnosis.

Therapy: The primary objective of FRI treatment is to achieve fracture consolidation, while avoiding osteomyelitis. Therapeutic options are removal of the implant, eradication of the infection with implant retention or suppression of FRI. A multidisciplinary team is recommended to develop a patient-specific, optimized surgical and antimicrobial therapy.

Keywords: Biofilm; Complication management; Fracture-related infection (FRI); Multidisciplinary team; Osteomyelitis.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / therapeutic use*
  • Biofilms
  • Debridement / methods*
  • Fractures, Bone / complications*
  • Fractures, Bone / microbiology
  • Fractures, Bone / surgery*
  • Humans
  • Osteomyelitis / diagnosis
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Postoperative Complications / microbiology*
  • Postoperative Complications / therapy
  • Surgical Wound Infection / diagnosis*
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / therapy*
  • Traumatology

Substances

  • Anti-Bacterial Agents