Clinical Priority Program Bone Infection

Bone Infection as an AO Trauma Clinical Priority Program (CPP)

Trauma surgeons have long recognized infections as one of the most serious and distressing complications of operative fracture care. While the incidence of fracture-related infection (FRI) is relatively low in closed fractures, the risk increases dramatically for open fractures, with an estimated 27 percent incidence in civilians and 40 percent in war injuries. However, surgical treatment options are often complicated by the need for fracture stability and implant removal.

Despite best current practice including antibiotic prophylaxis, we have failed to eliminate costly bone infection. The increasing prevalence of drug-resistant pathogens signals a new obstacle. Furthermore, despite elaborate revision protocols, treatment failure rates can be as high as 50 percent, leading to loss of function, arthrodesis, amputation, and death. Therefore, infection has made a serious resurgence as a major complication of orthopedic trauma and reconstruction surgery. As we approach the limit of the effectiveness of current techniques, novel approaches to infection management must be developed.