The global burden of fracture-related infection: can we do better?

Willem-Jan Metsemakers; T Fintan Moriarty; Mario Morgenstern; Leonard Marais; Jolien Onsea; Robert V O'Toole; Melissa Depypere; William T Obremskey; Michael H J Verhofstad; Martin McNally; Saam Morshed; Marjan Wouthuyzen-Bakker; Charalampos Zalavras

doi:10.1016/S1473-3099(23)00503-0

The global burden of fracture-related infection: can we do better?

Lancet Infect Dis. 2023 Nov 29:S1473-3099(23)00503-0. doi: 10.1016/S1473-3099(23)00503-0. Online ahead of print.

Affiliations

¹ Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium. Electronic address: willem-jan.metsemakers@uzleuven.be.
² AO Research Institute Davos, Davos, Switzerland; Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland.
³ Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland.
⁴ Department of Orthopaedics, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
⁵ Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
⁶ Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
⁷ Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
⁸ Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
⁹ Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands.
¹⁰ The Bone Infection Unit, Oxford University Hospitals, Oxford, UK.
¹¹ Department of Orthopaedic Surgery and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
¹² Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
¹³ Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 38042164
DOI: 10.1016/S1473-3099(23)00503-0

Abstract

Fracture-related infection is a major complication related to musculoskeletal injuries that not only has important clinical consequences, but also a substantial socioeconomic impact. Although fracture-related infection is one of the oldest disease entities known to mankind, it has only recently been defined and, therefore, its global burden is still largely unknown. In this Personal View, we describe the origin of the term fracture-related infection, present the available data on its global impact, and discuss important aspects regarding its prevention and management that could lead to improved outcomes in both high-resource and low-resource settings. We also highlight the need for health-care systems to be adequately compensated for the high cost of human resources (trained staff) and well-equipped facilities required to adequately care for these complex patients. Our aim is to increase awareness among clinicians and policy makers that fracture-related infection is a disease entity that deserves prioritisation in terms of research, with the goal to standardise treatment and improve patient outcomes on a global scale.

Publication types

Review