Fracture-related infection

Fracture-related infection

After surgical treatment of a bone fracture, an infection can sometimes develop around the bone and the implanted hardware. This condition is known as a fracture-related infection (FRI). FRI is a serious complication that can significantly delay recovery, affect quality of life, and lead to substantial healthcare costs.

In recent years, an international consensus definition of FRI has been established. This has improved the recognition of these infections and enabled better comparison between studies. However, many uncertainties remain regarding the optimal diagnosis and treatment of FRI.

This dissertation of Jonathan Sliepen aims to improve the understanding of FRI and to optimise its treatment. It shows that commonly used criteria for surgical site infections often fail to detect FRI, while dedicated FRI criteria are more reliable. The research also demonstrates that the timing of infection onset does not reliably predict the responsible bacteria, which has important implications for antibiotic selection.

Various treatment strategies are evaluated. The findings suggest that both single-stage and two-stage surgical approaches can achieve good outcomes, and that retaining implanted hardware may be possible even several weeks after the initial surgery. The use of antibiotic-loaded bone substitutes appears to reduce the risk of recurrent infection. Given the complexity of FRI, there is an urgent need for large international collaborations using uniform terminology to gather high-quality data and develop new, alternative treatment strategies.