Challenges and countermeasures in the diagnosis and treatment of fracture-related infection
10.3760/cma.j.cn501098-20250110-00025
- VernacularTitle:骨折相关感染诊疗面临的挑战与应对策略
- Author:
Nan JIANG
1
;
Bin YU
1
Author Information
1. 南方医科大学南方医院创伤骨科，广东省创伤骨科研究所，广州 510515
- Publication Type:Journal Article
- Keywords:
Bone diseases, infectious;
Osteomyelitis;
Internal fixators;
Anti-bacterial agents;
Calcium sulfate
- From:
Chinese Journal of Trauma
2025;41(7):627-634
- CountryChina
- Language:Chinese
-
Abstract:
Fracture-related infection (FRI) is defined as a bone infection occurring at fracture sites or implant interfaces following open fractures or internal fixation, primarily caused by pathogenic bacterial colonization or compromised host immunity, with variable involvement of adjacent soft tissues. As a catastrophic complication of extremity trauma, FRI continues to pose substantial clinical challenges. Diagnostic difficulties stem from multiple factors: imaging confounded by traumatic and postoperative changes, limited specificity of conventional inflammatory biomarkers, high false-negative rates in standard microbial cultures, and lack of standardized histopathological criteria. Therapeutically, challenges persist, including uncertainty regarding optimal debridement extent, lack of evidence-based criteria for implant retention during early infection, ongoing controversy over contentious administration routes and duration of systemic antibiotics, and elevated complication rates in major bone defect reconstruction. To this end, the authors explored challenges and corresponding management strategies in the clinical diagnosis and treatment of FRI, aiming to enhance orthopedic surgeons′ clinical recognition of it.
