Emerging concepts in the diagnosis and treatment of fracture-related infections.
8 affiliations
- 1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT.
- 2Department of Internal Medicine, Division of Infectious Diseases, University of Utah, Salt Lake City, UT.
- 3Department of Orthopaedic Surgery, Rutgers-RWJBH-Cooperman Barnabas/Jersey City Medical Center, Jersey City, NJ.
- 4Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.
- 5Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
- 6Department of Engineering, Thayer School of Engineering, Dartmouth, Hanover, NH.
- 7Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.
- 8Department of Orthopaedic Surgery, Beath Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Abstract
Fracture-related infections (FRIs) remain a significant challenge in orthopaedic trauma, as they are a consistent source of poor patient outcomes and elevated health care costs. FRIs have traditionally been diagnosed using findings from physical examination, blood tests, and advanced imaging, and the mainstay of treatment has been bony debridement, removal of hardware, and local and systemic antibiotic therapy. Although patients with FRIs were historically treated with IV antibiotics, randomized clinical trials have since demonstrated that oral antibiotics can be just as effective while mitigating the risks associated with prolonged IV antibiotics. Emerging biomarkers for infection, including molecular methods such as transcriptomics, proteomics, metabolomics, and next-generation sequencing, offer the ability to more precisely identify infection from a wider range of microbes. Fluorescence-guided debridement surgery presents a strategy to better visualize infected tissue and decrease surgeon reliance on subjective intraoperative findings. The purpose of this review is to present emerging tools and treatment algorithms that might be able to increase the accuracy and precision with which FRIs are diagnosed and managed.
Related
- Mycobacterium marinum as a rare cause of soft tissue infections of the upper extremity: A multidisciplinary multicenter approach to symptoms, diagnosis and treatment.
- High-Protein Intake Impact on Human and Animal Kidney Function Across the Lifespan: Clinical Evidence and Emerging Concepts
- Pulmonary Carcinoid Tumors (Lung Carcinoids): Current Concepts in Diagnosis and Management
- From periodontal inflammation to hepatic immune remodeling: emerging concepts of myeloid reprogramming in stage-dependent MASLD
- Emerging concepts on one-carbon metabolism as a unique and actionable vulnerability in cancer.
BibTeX
@article{pedrick2026emerging,
title = {{Emerging concepts in the diagnosis and treatment of fracture-related infections.}},
author = {Emily Pedrick and Laura Certain and Richard Yoon and Roman M Natoli and Ida L Gitajn and Yue Tang and Logan M Bateman and Shudong Jiang and Gerard Slobogean and Robert V O'Toole and Jonathan Elliott and John Wixted and Justin Haller},
journal = {OTA international : the open access journal of orthopaedic trauma},
year = {2026},
month = oct,
doi = {10.1097/oi9.0000000000000529},
url = {https://europepmc.org/article/MED/42953675},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Emerging concepts in the diagnosis and treatment of fracture-related infections.
AU - Emily Pedrick
AU - Laura Certain
AU - Richard Yoon
AU - Roman M Natoli
AU - Ida L Gitajn
AU - Yue Tang
AU - Logan M Bateman
AU - Shudong Jiang
AU - Gerard Slobogean
AU - Robert V O'Toole
AU - Jonathan Elliott
AU - John Wixted
AU - Justin Haller
PY - 2026
DA - 2026/10/23
JO - OTA international : the open access journal of orthopaedic trauma
DO - 10.1097/oi9.0000000000000529
UR - https://europepmc.org/article/MED/42953675
AB - Fracture-related infections (FRIs) remain a significant challenge in orthopaedic trauma, as they are a consistent source of poor patient outcomes and elevated health care costs. FRIs have traditionally been diagnosed using findings from physical examination, blood tests, and advanced imaging, and the mainstay of treatment has been bony debridement, removal of hardware, and local and systemic antibiotic therapy. Although patients with FRIs were historically treated with IV antibiotics, randomized clinical trials have since demonstrated that oral antibiotics can be just as effective while mitigating the risks associated with prolonged IV antibiotics. Emerging biomarkers for infection, including molecular methods such as transcriptomics, proteomics, metabolomics, and next-generation sequencing, offer the ability to more precisely identify infection from a wider range of microbes. Fluorescence-guided debridement surgery presents a strategy to better visualize infected tissue and decrease surgeon reliance on subjective intraoperative findings. The purpose of this review is to present emerging tools and treatment algorithms that might be able to increase the accuracy and precision with which FRIs are diagnosed and managed.
SN - 2574-2167
ER -