Articles | Volume 11, issue 4
https://doi.org/10.5194/jbji-11-401-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-11-401-2026
© Author(s) 2026. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Management of fracture-related infection in low-resource settings in Africa: recommendations and guidelines from an international expert group
Loïc Fonkoué
Department of Orthopedics and Trauma, Yaoundé General Hospital, Yaounde, Cameroon
Department of surgery and specialties, University of Yaounde 1, Yaounde, Cameroon
Experimental and clinical research institute, Université Catholique de Louvain, Brussels, Belgium
Elizabeth K. Tissingh
CORRESPONDING AUTHOR
Royal National Orthopedic Hospital NHS TRUST, London, UK
King's Global Health Partnerships, School of Life Course and Population Sciences, King's College London, London, UK
Leonard C. Marais
Department of Orthopaedics, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Mbonisi Malaba
Kijabe Medical Centre, Kijabe, Kenya
Kidanemariam Abrha
Ayder Comprehensive Specialized Hospital, Mekelle University College of Health Science, Mekelle, Ethiopia
Jamie Ferguson
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
Mario Morgenstern
Center for Musculoskeletal Infections (ZMSI), University Hospital Basel, Basel, Switzerland
Deformity Correction and Bone Healing Unit (DBU-Basel), Department of Orthopedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland
Olivier Cornu
Orthopaedic and Trauma Department, University Hospital Saint-Luc UCL 1200 – Brussels, Belgium
Neuromuskuloskeletal Laboratory (NMSK), Clinical and experimental Research Institute (IREC), UCLouvain, 1200 Brussels, Belgium
Maritz Laubscher
Orthopaedic Research Unit (ORU), Groote Schuur Hospital, University of Cape Town, South Africa
Randy Buzisa Mbuku
Orthopaedic and Trauma Department, University Hospital Saint-Luc UCL 1200 – Brussels, Belgium
Université Catholique de Louvain, Louvain Drug Research Institute, Pharmacologie cellulaire et moléculaire, Brussels, Belgium
George W. Galiwango
CORSU Rehabilitation Hospital, Kisubi, Uganda
Matthijs Botman
Amsterdam University Medical Centre, Amsterdam, the Netherlands
Global Surgery Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
Justyna Wojno
Lancet laboratories, Microbiology Department, Cape Town, South Africa
Mtebe Venance Majigo
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
Claude Martin Jr.
AO Alliance Foundation Chur, Chur, Switzerland
William James Harrison
AO Alliance Foundation Chur, Chur, Switzerland
Countess of Chester NHS Foundation Trust, Chester, United Kingdom
Alexander Thomas Schade
Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
Kebba Marenah
School of Medicine and Allied Health Sciences, University of the Gambia, Banjul, Gambia
Malvern Nyamutora
Parirenyatwa Hospital, Harare, Zimbabwe
Phiona E. Namale
Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
Vuyisa Mdingi
Department of Orthopaedics, School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Martin McNally
Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
Latest update: 09 Jul 2026
Short summary
Fracture-related infection is a serious problem after broken bones, especially in low-resource settings where specialist care and services are limited. An international expert group developed practical recommendations adapted to these realities. The guidance focuses on early fracture care, simple diagnostic approaches, flexible antibiotic use, affordable local treatments, good soft tissue management, and teamwork, aiming to improve safe and effective care in resource-limited environments.
Fracture-related infection is a serious problem after broken bones, especially in low-resource...