Thompson Emmet, Qureshi Amir
Limb Reconstruction Service, Trauma & Orthopaedic Department, University Hospital Southampton, Southampton, UK.
J Orthop. 2024 Feb 12;53:59-72. doi: 10.1016/j.jor.2024.02.011. eCollection 2024 Jul.
Fracture-related infection (FRI) is a devasting complication for both patients and their treating Orthopaedic surgeon that can lead to loss of limb function or even amputation. The unique and unpredictable features of FRI make its diagnosis and treatment a significant challenge. It has substantial morbidity and financial implications for patients, their families and healthcare providers. In this article, we perform an in-depth and comprehensive review of FRI through recent and seminal literature to highlight evolving definitions, diagnostic and treatment approaches, focusing on common pathogens such as Staphylococcus aureus polymicrobial infections and multi-drug-resistant organisms (MDRO). Furthermore, multiple resistance mechanisms and adaptations for microbial survival are discussed, as well as modern evidence-based medical and surgical advancements in treatment strategies in combating FRI.
骨折相关感染（FRI）对于患者及其主治骨科医生而言都是一种极具破坏性的并发症，可能导致肢体功能丧失甚至截肢。FRI独特且不可预测的特征使其诊断和治疗成为一项重大挑战。它给患者、其家庭以及医疗服务提供者带来了巨大的发病率和经济影响。在本文中，我们通过近期的重要文献对FRI进行了深入全面的综述，以突出不断演变的定义、诊断和治疗方法，重点关注常见病原体，如金黄色葡萄球菌多重微生物感染和多重耐药菌（MDRO）。此外，还讨论了多种耐药机制以及微生物生存的适应性，以及在对抗FRI的治疗策略中基于现代循证医学的医疗和外科进展。
