Education and Research

16. March 2018

International Consensus Meeting on the Diagnosis and Treatment of Fracture-Related Infection (FRI), Zürich, February 2018.

The AO Foundation has consistently supported educational and research activities focused on the clinical problem of Fracture-Related Infection (FRI). As part of this ongoing effort, the AO Foundation hosted a consensus meeting on the diagnosis and treatment of FRI in Zürich in February 2018. The meeting was attended by 35 experts and key opinion leaders in the field of FRI including trauma surgeons, infection disease specialists, a plastic surgeon, clinical researchers and research scientists. 

Members of the international consensus group from Argentina, South Africa, France, Germany, The Netherlands, Belgium, Switzerland, the UK, and the USA assembled in Zürich to discuss the diagnosis and treatment of FRI.

The quality of clinical literature available on fracture-related complications has always been a challenge. This is due to the lack of a definition for FRI, and the lack of widely accepted or adopted protocols regarding the diagnosis and treatment of FRI. To address this issue, and with the support of the AO Foundation (ARI, AOTrauma and AOTK) and the European Bone and Joint Infection Society (EBJIS), a first meeting of this expert group was convened in Davos, Switzerland, in December 2016. 


The group successfully established a definition of FRI at this first meeting, which has since been published as a consensus paper. Such a consensus definition will enable improvements in clinical studies on infection incidence, costs of treatment, effectiveness of treatment strategies and outcomes for patients.

Over the past 12 months, the expert group has shifted attention to the next phase, the development of consensus on diagnosis and treatment principles for FRI. In reflecting the greater complexity of this question, and to engage with other professional organisations, the group has grown to include external partners. Joining the AO Research Institute Davos (ARI), AOTrauma and the AOTK Anti-Infection task force (AITF), is the EBJIS, the Orthopaedic Trauma Association (OTA), and the Pro-Implant Foundation​, as well as a broadened panel of experts with extensive clinical experience in FRI. A first meeting of the expanded expert group (FRI Consensus Group) took place in Zürich in February 2018 to discuss guiding principles on the diagnosis and treatment of FRI. Prior to the meeting, the group was asked to review and consider the published literature on FRI, within nine specific concepts that were then presented for discussion in dedicated sessions during the meeting. The concepts included were: 

  • Diagnosis
  • Classification
  • Treatment concepts (e.g. local antimicrobial strategies, soft tissue management)
  • Standardization of outcome measurements​​
​Complete meeting program​

A broad consensus was achieved for each topic, and recommendations will be developed and published in the coming months to share these guiding principles on the diagnosis and treatment of FRI with trauma surgeons worldwide. 

The FRI Consensus Group is proud to report this milestone achievement, where multiple international organizations have come together to try and improve the care of patients with FRI.



Icon Consensus Meeting Chairs Willem-Jan Metsemakers, (centre), with Martin McNally of the EBJIS (left) and William Obremskey of the OTA (right).​
Icon Andrej Trampuz of the Pro Implant Foundation, Charité, Berlin, (right of image) and Michael Raschke , University Hospital Muenster, Germany (left).
Icon Leonard Marais of Grey’s Hospital, University of KwaZulu-Natal, South Africa (centre) with Richard Kuehl of University Hospital Basel (left) and Carlos Sancineto of Hospital Italiano de Buenos Aires, Argentina (right).