Basic science and current management for fracture-related infections

Fracture-related infections (FRIs) play a significant role in poor clinical outcomes and patient morbidity for patients with orthopaedic trauma. FRI diagnosis has become more standardized, which will strengthen research efforts to identify prognostic factors and improve clinical management. Biofilm research continues to advance our understanding of how FRIs develop and improve FRI prevention. Antibiotic bead pouches are a useful technique to locally administer high antibiotic concentrations for open fractures that are at high risk for FRI. There are a variety of techniques for managing critical sized bone defects in the setting of infection including serial bone grafting, induced membrane, distraction osteogenesis, and vascularized bone transfer. Management of acute and chronic FRI relies on successful debridement of necrotic tissue with infection eradication and bony reconstruction.