Recent advances regarding diagnosis and treatment of fracture-related infection_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIANG Nan ^1,2 ,  YU Bin ¹

1. Guangdong Institute of Orthopaedics and Traumatology, Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou Guangdong, 510515, P. R. China;
2. Department of Trauma Emergency Center, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou Jiangxi, 341000, P. R. China;

Corresponding author：

YU Bin, Email: yubinol@163.com

Keywords：

Fracture-related infection; osteomyelitis; diagnosis; treatment; research progress

DOI：

10.7507/1002-1892.202505073

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the current research status on the diagnosis and treatment of fracture-related infection (FRI). Methods The research literature in the field of FRI both domestically and internationally in recent years were widely reviewed, and the research progress of FRI from the aspects of definition and classification, epidemiological characteristics, diagnosis and treatment elaborated, in order to provide reference for clinical practices. Results In recent years, specific classifications for FRI have gradually emerged. FRI is characterized by high incidence, high recurrence, high disability rates, and significant economic costs. Key diagnostic points include clinical signs and symptoms, imaging tests, serological biomarkers, pathogen identification, and histopathological examination. Treatment principles encompass debridement, management of implants (retention or removal), systemic and local antibiotic use, reconstruction of bone and soft tissue defects, and functional and psychological rehabilitation. Conclusion Although FRI is a catastrophic complication following limb bone trauma, early precise diagnosis and standardized treatment are key to improving cure rates, reducing recurrence, and enhancing patients’ quality of life.

Citation： JIANG Nan, YU Bin. Recent advances regarding diagnosis and treatment of fracture-related infection. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(10): 1342-1350. doi: 10.7507/1002-1892.202505073 Copy

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27.	Hoffmann A, Hoffmann J, Ruegamer T, et al. New diagnostic techniques for diagnosing facture-related infections. Injury, 2024, 55 Suppl 6: 111898. doi: 10.1016/j.injury.2024.111898.
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31.	Li B, Liu C, Alt V, et al. Multidisciplinary approach and host optimization for fracture-related infection management. Injury, 2024, 55 Suppl 6: 111899. doi: 10.1016/j.injury.2024.111899.
32.	Langit MB, Tay KS, Al-Omar HK, et al. Surgical debridement in long bone chronic osteomyelitis: is wide tumour-like resection necessary? Bone Jt Open, 2023, 4(8): 643-651.
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3.
4.
5.
6.
7.
8.
9. Foster AL, Warren J, Vallmuur K, et al. A population-based epidemiological and health economic analysis of fracture-related infection. Bone Joint J, 2024, 106-B(1): 77-85.
10.
11. Reátiga Aguilar J, Gonzalez Edery E, Guzmán Badrán J, et al. Open tibial plateau fractures: Infection rate and functional outcomes. Injury, 2023, 54 Suppl 6: 110720. doi: 10.1016/j.injury.2023.04.007.
12.
13.
14. Metsemakers WJ, Moriarty TF, Morgenstern M, et al. The global burden of fracture-related infection: can we do better? Lancet Infect Dis, 2024, 24(6): e386-e393.
15.
16.
17.
18.
19.
20.
21.
22.
23. Natoli RM, Malek S. Fracture-related infection blood-based biomarkers: Diagnostic strategies. Injury, 2024, 55 Suppl 6: 111823. doi: 10.1016/j.injury.2024.111823.
24. Trenkwalder K, Hackl S, Weisemann F, et al. The value of current diagnostic techniques in the diagnosis of fracture-related infections: Serum markers, histology, and cultures. Injury, 2024, 55 Suppl 6: 111862. doi: 10.1016/j.injury.2024.111862.
25.
26.
27. Hoffmann A, Hoffmann J, Ruegamer T, et al. New diagnostic techniques for diagnosing facture-related infections. Injury, 2024, 55 Suppl 6: 111898. doi: 10.1016/j.injury.2024.111898.
28.
29.
30.
31. Li B, Liu C, Alt V, et al. Multidisciplinary approach and host optimization for fracture-related infection management. Injury, 2024, 55 Suppl 6: 111899. doi: 10.1016/j.injury.2024.111899.
32. Langit MB, Tay KS, Al-Omar HK, et al. Surgical debridement in long bone chronic osteomyelitis: is wide tumour-like resection necessary? Bone Jt Open, 2023, 4(8): 643-651.
33. Baertl S, Rupp M, Alt V. The DAIR-procedure in fracture-related infection-When and how. Injury, 2024, 55 Suppl 6: 111977. doi: 10.1016/j.injury.2024.111977.
34.
35.
36.
37.
38.
39.
40.
41.
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43.
44.
45. Chen B, Moriarty TF, Metsemakers WJ, et al. Phage therapy: A primer for orthopaedic trauma surgeons. Injury, 2024, 55 Suppl 6: 111847. doi: 10.1016/j.injury.2024.111847.
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