Journal Article

Fracture-Related Infections: Current Status and Perspectives from the International Society of Antimicrobial Chemotherapy

Scobie, Antonia, Chan, Monica, Pagliano, Pasquale, Giordano, Gérard, Ascione, Tiziana, Lourtet-Hascoët, Julie, Bonnet, Eric, Esposito, Silvano, Saeed, Kordo, Spera, Anna Maria, Ünal, Serhat

2025

Overview

Fracture-related infections (FRIs) represent a significant complication in orthopedic trauma care, often leading to delayed bone healing, prolonged hospital stays, and increased patient morbidity. Pathogenesis involves microbial contamination during injury or surgery, compounded by patient-related risk factors such as diabetes, smoking, or immunosuppression. Diagnosis of FRI relies on a combination of clinical, radiological, and microbiological criteria. Common signs include persistent pain, swelling, erythema, purulent discharge, and non-union of the fracture. FRIs are classified based on the timing of infection onset into acute, delayed, and chronic forms, each requiring tailored management strategies. Treatment generally involves aggressive surgical debridement, possible hardware removal or retention, and targeted antibiotic therapy. In cases of severe tissue loss, reconstructive procedures may be necessary to restore bone and soft tissue integrity. Treatment strategies include early administration of prophylactic antibiotics, meticulous surgical technique, and timely soft tissue coverage in open fractures. A multidisciplinary approach involving orthopedic surgeons, infectious disease specialists, and microbiologists is essential for successful management. Early recognition and appropriate intervention are crucial to improving outcomes and minimizing long-term disability in patients with fracture-related infections.

• Publisher: MDPI AG,Multidisciplinary Digital Publishing Institute (MDPI)
• Subject: Antibacterial agents / Antibiotics / Bacteria / Biofilms / Bone healing / Bone surgery / Cancer / Chemotherapy / Chronic infection / Diabetes mellitus / Epidemiology / Erythema / Evidence-based medicine / fracture-related infection / Fractures / Gram-negative bacteria / Gram-positive bacteria / Health aspects / Health services / Immunosuppression / Infection / Infectious diseases / internal fixation / Methicillin / Microbial contamination / Microbiology / Microorganisms / Morbidity / Nonunion / Open fractures / open limb / orthopedic infection / Orthopedics / osteomyelitis / osteosynthesis / Pathogenesis / Pathogens / Patients / Review / Risk factors / Soft tissues / Staphylococcus infections / Strategic planning (Business) / Trade and professional associations / Trauma