Effect of mechanical stability of osteosynthesis on infection rates: Timing of temporary and definitive fixation

IF 2.2 3区 医学 Q3 CRITICAL CARE MEDICINE
Emmanuele Santolini , Vincenzo Giordano , Peter V. Giannoudis
{"title":"Effect of mechanical stability of osteosynthesis on infection rates: Timing of temporary and definitive fixation","authors":"Emmanuele Santolini ,&nbsp;Vincenzo Giordano ,&nbsp;Peter V. Giannoudis","doi":"10.1016/j.injury.2024.111845","DOIUrl":null,"url":null,"abstract":"<div><div>Fracture related infection (FRI) remains one of the most challenging complications of orthopaedic trauma surgery. Several factors contribute to FRI development but, among those, particularly interesting from the orthopaedic surgeon's perspective is the contribution of mechanical stability and timing of fracture fixation. These are indeed crucial factors both in prevention and treatment of FRI and are directly influenced by the surgeon's work. While the role of stability has been studied and discussed, the pathophysiological process regulating such role and how this influences surgeon's treatment decision making is still debated. The same applies to the ideal timing of temporary or definitive fixation which varies according to the clinical scenario considered.</div><div>In the present narrative review, we described the influence of mechanical stability on both FRI pathophysiology and on the decision making of FRI treatment. In addition, we analysed the impact of the timing of fracture fixation on the risk of FRI development particularly in those clinical scenarios where it has been shown to be specifically relevant, such as fractures affecting segments with poor soft tissue envelope, open fractures, damage control orthopaedics, and the need for soft tissue coverage.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"55 ","pages":"Article 111845"},"PeriodicalIF":2.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Injury-International Journal of the Care of the Injured","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0020138324005746","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Fracture related infection (FRI) remains one of the most challenging complications of orthopaedic trauma surgery. Several factors contribute to FRI development but, among those, particularly interesting from the orthopaedic surgeon's perspective is the contribution of mechanical stability and timing of fracture fixation. These are indeed crucial factors both in prevention and treatment of FRI and are directly influenced by the surgeon's work. While the role of stability has been studied and discussed, the pathophysiological process regulating such role and how this influences surgeon's treatment decision making is still debated. The same applies to the ideal timing of temporary or definitive fixation which varies according to the clinical scenario considered.
In the present narrative review, we described the influence of mechanical stability on both FRI pathophysiology and on the decision making of FRI treatment. In addition, we analysed the impact of the timing of fracture fixation on the risk of FRI development particularly in those clinical scenarios where it has been shown to be specifically relevant, such as fractures affecting segments with poor soft tissue envelope, open fractures, damage control orthopaedics, and the need for soft tissue coverage.
骨合成的机械稳定性对感染率的影响:临时固定和最终固定的时机
骨折相关感染(FRI)仍然是创伤骨科手术中最具挑战性的并发症之一。FRI的形成有多种因素,但从矫形外科医生的角度来看,其中尤其值得关注的是机械稳定性和骨折固定时机。这些确实是预防和治疗 FRI 的关键因素,并直接受到外科医生工作的影响。虽然人们已经对稳定性的作用进行了研究和讨论,但对调节这种作用的病理生理过程以及它如何影响外科医生的治疗决策仍存在争议。在本综述中,我们阐述了机械稳定性对 FRI 病理生理学和 FRI 治疗决策的影响。此外,我们还分析了骨折固定时机对 FRI 发生风险的影响,尤其是在已证明与 FRI 特别相关的临床情况下,如影响软组织包膜不良节段的骨折、开放性骨折、损伤控制矫形以及需要软组织覆盖等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.00
自引率
8.00%
发文量
699
审稿时长
96 days
期刊介绍: Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信