Systematic Diagnosis and Treatment Principles for Acute Fracture-Related Infections
10.12671/jkfs.2023.36.4.148
- Author:
Jeong-Seok CHOI
1
;
Jun-Hyeok KWON
;
Seong-Hyun KANG
;
Yun-Ki RYU
;
Won-Seok CHOI
;
Jong-Keon OH
;
Jae-Woo CHO
Author Information
1. Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea
- Publication Type:REVIEW ARTICLE
- From:Journal of the Korean Fracture Society
2023;36(4):148-161
- CountryRepublic of Korea
- Language:English
-
Abstract:
Acute fracture-related infection (FRI) is a common and serious complication of fracture treatment. The clinical symptoms of the patient and the results of the serological, radiological, and histopathologi-cal examinations can be divided into ‘Confirmatory’ criteria and ‘Suggestive’ criteria, allowing for the diagnosis of FRI. Treatment principles can be broadly categorized into (1) the DAIR (Debridement, Antimicrobial therapy, Implant Retention) method and (2) the staged reconstruction method. The choice of treatment depends on factors such as the time elapsed after infection, stability of the internal fixation device, reduction status, host physiology, and virulence of the pathogens. Thorough surgical debridement and irrigation, ensuring stability at the fracture site, reconstruction of bone defects, and appropriate soft tissue coverage, along with antibiotic therapy, are essential to suppress or eradicate the infection. The restoration of limb function should be promoted through proper soft tissue coverage and bone union at the fracture site.
