Tay Hui Wen, Tay Kae Sian
Singapore General Hospital Department of Orthopaedic Surgery, Singapore.
J Orthop. 2024 Apr 10;55:64-68. doi: 10.1016/j.jor.2024.03.034. eCollection 2024 Sep.
Fracture related infection (FRI) refers to pathogens infecting a fracture site and hence impeding fracture healing. It is a significant complication that carries substantial disease burden and socio-economic costs, but has had limited scientific development. Hence, this paper will review the existing strategies for early detection of FRI, in the form of serum markers, molecular diagnostics and imaging modalities, and further discuss potential future directions for improved detection of FRI.
The Anti-infection Global Expert Committee (AIGEC) developed a consensus definition for FRI in 2017, which includes confirmatory and suggestive criteria for diagnosis of FRI. Existing strategies for diagnosis include clinical, laboratory, histopathological, microbiological and radiological investigations.
With increasing recognition of FRI, early detection is crucial for early treatment to be enforced. We have identified potential areas for future development in diagnostics for early detection of FRI, which are discussed in this manuscript. They include inflammatory cytokines, serum calcium levels, platelet count, improved management of histopathological and microbiological specimens, metagenomics, wound biomarkers, gut microbiota analysis, and novel imaging technologies.
骨折相关感染（FRI）是指病原体感染骨折部位，从而阻碍骨折愈合。它是一种严重的并发症，带来巨大的疾病负担和社会经济成本，但科学进展有限。因此，本文将以血清标志物、分子诊断和成像方式等形式，综述现有的FRI早期检测策略，并进一步探讨改善FRI检测的潜在未来方向。
FRI的现有诊断策略：抗感染全球专家委员会（AIGEC）在2017年制定了FRI的共识定义，其中包括FRI诊断的确证标准和提示标准。现有的诊断策略包括临床、实验室、组织病理学、微生物学和放射学检查。
FRI早期检测的未来方向：随着对FRI的认识不断提高，早期检测对于实施早期治疗至关重要。我们已经确定了FRI早期检测诊断未来发展的潜在领域，本文将对此进行讨论。它们包括炎性细胞因子、血清钙水平、血小板计数、组织病理学和微生物学标本管理的改进、宏基因组学、伤口生物标志物、肠道微生物群分析以及新型成像技术。
