Recent advancements and future directions in fracture related infections: A scoping review.

Injury · Nov 2024 · Review

Walter N, Bärtl S, Alt V, Rupp M

Department for Trauma Surgery, University Hospital Regensburg, Franz- Josef-Strauß-Allee 11, Germany

Orthopaedic Trauma

SUMMARY — THE REDUCTIONThis scoping review summarizes recent advances in fracture-related infection diagnosis and treatment, including better biomarkers, antimicrobial implants, immunomodulatory therapies, and phage/enzybiotic alternatives to antibiotics.
Abstract, as published

Fracture-related infections (FRIs) are complex challenges in orthopedic and trauma surgery, driving ongoing advancements in diagnostics, therapeutics, and management strategies. This scoping review examines recent progress and future directions in FRI management. Diagnostic enhancements encompass standardized definitions, improved biomarkers, advanced microbiological techniques, and innovative imaging modalities. Promising future diagnostics may include point-of-care testing, advanced imaging with enhanced specificity, and machine learning algorithms. Advancements in implant technology emphasize materials science, surface modifications, and personalized 3D printing, enhancing durability and antimicrobial efficacy. Immunomodulatory therapies targeting T cell dysfunction offer potential in addressing FRI chronicity. Enzybiotics and phages present promising alternatives to combat antibiotic resistance, with enzybiotics demonstrating effectiveness against biofilm-associated infections. Patient optimization, multidisciplinary approaches and specialized reference centers play vital roles in comprehensive FRI management, particularly crucial in resource-constrained settings. Collaboration and investment in research and technology are imperative for harnessing the full potential of these advancements and improving global FRI management outcomes. Addressing these complexities necessitates a multifaceted approach integrating clinical expertise, technological innovation, and global cooperation to optimize patient care and mitigate the burden of FRI worldwide.

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