Musculoskeletal sepsis: principles of treatment.

Musculoskeletal sepsis is infection of bone, joints, muscles, and skin and often occurs after open fractures. Thus, the main objective in the treatment of open fractures in restoration of function and prevention of infection. It is important to consider all open fracture wounds as contaminated. The principles of open fracture treatment include taking appropriate cultures, instituting immediate systemic antibiotic therapy, surgical débridement and wound management, stabilizing the fracture, and early bone grafting when indicated. The open tibial fracture, classified according to Gustilo and Anderson, serves as an exemplary model for musculoskeletal sepsis because this type of injury is described extensively in the literature. Early diagnosis and effective surgical and antibiotic management can control musculoskeletal sepsis, and the suppression of infection may last a lifetime.