Recent advancements and future directions in fracture related infections: A scoping review
Nike Walter1, Susanne Bärtl1, Volker Alt1
1Department for Trauma Surgery, University Hospital Regensburg, Franz- Josef-Strauß-Allee 11, Regensburg, 93053, Germany.
Abstract:
Fracture-related infections (FRIs) are complex challenges in orthopedic and trauma surgery, driving ongoing advancements in diagnostics, therapeutics, and management strategies. This scoping review examines recent progress and future directions in FRI management. Diagnostic enhancements encompass standardized definitions, improved biomarkers, advanced microbiological techniques, and innovative imaging modalities. Promising future diagnostics may include point-of-care testing, advanced imaging with enhanced specificity, and machine learning algorithms. Advancements in implant technology emphasize materials science, surface modifications, and personalized 3D printing, enhancing durability and antimicrobial efficacy. Immunomodulatory therapies targeting T cell dysfunction offer potential in addressing FRI chronicity. Enzybiotics and phages present promising alternatives to combat antibiotic resistance, with enzybiotics demonstrating effectiveness against biofilm-associated infections. Patient optimization, multidisciplinary approaches and specialized reference centers play vital roles in comprehensive FRI management, particularly crucial in resource-constrained settings. Collaboration and investment in research and technology are imperative for harnessing the full potential of these advancements and improving global FRI management outcomes. Addressing these complexities necessitates a multifaceted approach integrating clinical expertise, technological innovation, and global cooperation to optimize patient care and mitigate the burden of FRI worldwide.
Insights
Fracture-related infections (FRIs) are complex orthopedic challenges. Recent advancements in diagnostics, implants, and therapies like enzybiotics offer new hope for managing these difficult infections.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Fracture-related infections (FRIs) pose significant challenges in orthopedic and trauma surgery.
- Current management strategies are evolving with new diagnostic and therapeutic approaches.
Purpose of the Study:
- To review recent advancements and future directions in the management of fracture-related infections.
- To highlight innovations in diagnostics, implant technology, and therapeutic interventions.
Main Methods:
- Scoping review of recent literature on FRI management.
- Analysis of advancements in diagnostic tools, materials science, and antimicrobial strategies.
Main Results:
- Diagnostic improvements include standardized definitions, biomarkers, advanced microbiology, and imaging.
- Implant technology advances focus on materials, surface modifications, and 3D printing for antimicrobial efficacy.
- Emerging therapies include immunomodulatory treatments, enzybiotics, and phages to combat antibiotic resistance.
Conclusions:
- Multifaceted approaches integrating clinical expertise, technological innovation, and global cooperation are essential for optimizing FRI patient care.
- Continued research and investment are crucial to address the global burden of fracture-related infections.
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