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[Diagnosis and treatment of fracture-related infections]
Geertje A M Govaert1,2, M Frank Termaat3, A W J M Glaudemans4
1UMC Utrecht, afd. Traumachirurgie, Utrecht.
Abstract:
Fracture-related infection (FRI) is a serious complication after fracture care and can lead to severe morbidity with loss of quality of life, a significant increase in medical expenses and loss of participation in work and social life. Early recognition, adequate surgical debridement, deep uncontaminated tissue cultures with (if indicated) soft tissue reconstruction and fracture stabilization followed by antibiotic therapy are the cornerstones of the successful management of FRI. Recently, in 2018, the AO/EBJIS consensus definition for FRI was published and both national and international working groups are being assembled and provide guidelines and tools for the care of patients with FRI. This paper is a synopsis of the Dutch guideline on FRI (2018), illustrated by a clinical case, and is aiming to provide an overview of the current knowledge on diagnosis and treatment of this disease.
Insights
Fracture-related infection (FRI) is a severe complication impacting quality of life and increasing costs. This paper reviews the Dutch guideline for diagnosing and treating FRI, emphasizing early recognition and appropriate management strategies.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Trauma Care
Background:
- Fracture-related infection (FRI) poses significant challenges, leading to severe morbidity, reduced quality of life, increased healthcare costs, and loss of social and professional participation.
- The 2018 AO/EBJIS consensus definition has improved understanding and management of FRI.
- National and international efforts are underway to develop guidelines and tools for effective FRI patient care.
Purpose of the Study:
- To provide a synopsis of the Dutch guideline on Fracture-related Infection (FRI) published in 2018.
- To offer an overview of current knowledge regarding the diagnosis and treatment of FRI.
- To illustrate guideline recommendations with a clinical case example.
Main Methods:
- Synopsis of the Dutch guideline on Fracture-related Infection (2018).
- Review of current literature and expert consensus on FRI diagnosis and management.
- Presentation and discussion of a relevant clinical case.
Main Results:
- Successful management of FRI hinges on early recognition, thorough surgical debridement, and obtaining deep, uncontaminated tissue cultures.
- Integrated treatment involves fracture stabilization, potential soft tissue reconstruction, and appropriate antibiotic therapy.
- The Dutch guideline provides a structured approach to the complex care of patients with FRI.
Conclusions:
- Adherence to established guidelines is crucial for optimizing outcomes in Fracture-related Infection.
- A multidisciplinary approach combining surgical intervention and antibiotic treatment is essential.
- This review aims to enhance the understanding and application of evidence-based practices for FRI management.
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