Pathogenesis and management of fracture-related infection.

Depypere M; Morgenstern M; Kuehl R; Senneville E; Moriarty TF; Obremskey WT; Zimmerli W; Trampuz A; Lagrou K; Metsemakers WJ

doi:10.1016/j.cmi.2019.08.006

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$Pathogenesis and management of fracture-related infection.$

Journal article

Pathogenesis and management of fracture-related infection.

Depypere M Department of Laboratory Medicine, University Hospitals Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Belgium. Electronic address: melissa.depypere@uzleuven.be.
Morgenstern M Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Switzerland.
Kuehl R Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland.
Senneville E Department of Infectious Diseases, Gustave Dron Hospital, University of Lille, Lille, France.
Moriarty TF AO Research Institute, Davos, Switzerland.
Obremskey WT Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
Zimmerli W Interdisciplinary Unit for Orthopaedic Infections, Kantonsspital Baselland, Liestal, Switzerland.
Trampuz A Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Centre for Musculoskeletal Surgery, Berlin, Germany.
Lagrou K Department of Laboratory Medicine, University Hospitals Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Metsemakers WJ Department of Trauma Surgery, University Hospitals Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Belgium.

2019-08-26

Published in:

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. - 2020

English BACKGROUND
Both fracture-related infections (FRIs) and periprosthetic joint infections (PJIs) include orthopaedic implant-associated infections. However, key aspects of management differ due to the bone and soft tissue damage in FRIs and the option of removing the implant after fracture healing. In contrast to PJIs, research and guidelines for diagnosis and treatment in FRIs are scarce.

OBJECTIVES
This narrative review aims to update clinical microbiologists, infectious disease specialists and surgeons on the management of FRIs.

SOURCES
A computerized search of PubMed was performed to identify relevant studies. Search terms included 'Fracture' and 'Infection'. The reference lists of all retrieved articles were checked for additional relevant references. In addition, when scientific evidence was lacking, recommendations are based on expert opinion.

CONTENT
Pathogenesis, prevention, diagnosis and treatment of FRIs are presented. Whenever available, specific data of patients with FRI are discussed.

IMPLICATIONS
Management of patients with FRI should take into account FRI-specific features. Treatment pathways should implement a multidisciplinary approach to achieve a good outcome. Recently, international consensus guidelines were developed to improve the quality of care for patients suffering from this severe complication, which are highlighted in this review.

Language