Infection after fracture osteosynthesis – Part II: Treatment. (20th February 2017)

• Record Type: Journal Article
• Authors: Fang, Christian; Wong, Tak-Man; To, Kelvin KW; Wong, Samson SY; Lau, Tak-Wing; Leung, Frankie
• Is Part Of: Journal of orthopaedic surgery. Volume 25:Number 1(2017)
• Publication Date: 2017-02-20
• Subjects: biofilms -- fracture fixation -- prosthesis-related infections -- surgical wound infection; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/2309499017692714
• Languages: English
• ISSNs: 1022-5536

Abstract

In the first part of this article, we have discussed the pathogenesis, clinical presentation, diagnosis and classification of infection after fracture osteosynthesis with implants, termed here as osteosynthesis-associated infection (OAI). Prolonged antibiotic treatment is usually necessary. Implant retention and maintenance of fracture stability to allow for fracture healing in spite of infection are allowed for OAI. Depending on the severity of infection, status of fracture healing and host status, the treatment follows five common pathways. These are non-operative treatment, debridement with implant retention, conversion of fixation, implant removal and suppression therapy. The decision-making process leading to each treatment pathway and challenging scenarios is discussed in detail.