Fracture-related infections after bone surgery are difficult to diagnose because bacteria can attach to metal implants and become hard to detect, especially when antibiotics have already been given. We compared two laboratory methods used to identify bacteria on removed implants in 157 patients. Each method alone missed some infections, but using both together improved detection and helped guide antibiotic treatment. Our findings support combining diagnostic approaches to improve patient care.

This article outlines 20 common errors in the prevention, diagnosis, and management of fracture-related infection (FRI), highlighting their clinical consequences and providing practical recommendations for avoiding them. By addressing typical pitfalls and emphasizing standardized procedures and interdisciplinary collaboration, the article aims to improve patient safety and treatment outcomes.

Septic arthritis is a dangerous joint infection that requires rapid treatment. We analysed patient data to test common blood and synovial fluid markers and a newly developed composite score combining these markers. The score demonstrated higher sensitivity than individual tests alone within this dataset. Prospective validation in larger cohorts is required before clinical application.

The antibiotic bead pouch is a useful technique for temporary soft tissue coverage. After the introduction of negative wound pressure therapy, it has fallen into oblivion. However, the technique has several advantages, which are highlighted in the present review article. After debridement, the antibiotic beads deliver high dosages of antibiotics suitable for bone cements. This enables a sterile wound, which might help to avoid either infection or progress of infection.

This case report is the first description of severe metabolic acidosis due to flucloxacillin therapy without relevant comedication that we know of. The described patient had been treated with flucloxacillin for 14 d due to intraoperative evidence of multisensitive Staphylococcus aureus due to periprosthetic shoulder infection. In patients on flucloxacillin therapy, acidosis should therefore always be considered as a differential diagnosis of tachypnoea or impaired mental status.