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
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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。
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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.
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