Articles | Volume 11, issue 1
https://doi.org/10.5194/jbji-11-53-2026
https://doi.org/10.5194/jbji-11-53-2026
Original full-length article
 | 
29 Jan 2026
Original full-length article |  | 29 Jan 2026

Diagnosis and management of fracture-related infections in a low-income country: a prospective study comparing current practice to international consensus guidelines

Loïc Fonkoué, Elizabeth K. Tissingh, Cilia Ngang, Olivier Kennedy Muluem, Jasmine Sibatcheu Simo, Richard Douvamai, Jean Bahebeck, Olivier Cornu, and Martin McNally

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Cited articles

ABJIN (African Bone and Joint Infection Network): Management of fracture-related infection in low-resource settings, AO Alliance clinical guidelines, https://ao-alliance.org/wp-content/uploads/2025/02/clinical-guidelines_fracture-related-infections_2025.pdf (last access: 15 November 2025), 2025. 
Alt, V., McNally, M., Wouthuyzen-Bakker, M., Metsemakers, W. J., Marais, L., Zalavras, C., and Morgenstern, M.: The FRI classification – A new classification of fracture-related infections, Injury, 55, 111831, https://doi.org/10.1016/j.injury.2024.111831, 2024. 
Asim, R., Fuchs, C. J., and Summers, N. A.: Evaluating the duration of antimicrobial therapy for the treatment of orthopedic hardware infections, Microbiol Spectr, 12, e0126924, https://doi.org/10.1128/spectrum.01269-24, 2024. 
Baertl, S., Rupp, M., and Alt, V.: The DAIR-procedure in fracture-related infection-When and how, Injury, 55 Suppl 6, 111977, https://doi.org/10.1016/j.injury.2024.111977, 2024. 
Bezstarosti, H., Van Lieshout, E. M. M., Voskamp, L. W., Kortram, K., Obremskey, W., McNally, M. A., Metsemakers, W. J., and Verhofstad, M. H. J.: Insights into treatment and outcome of fracture-related infection: a systematic literature review, Arch Orthop Trauma Surg, 139, 61–72, https://doi.org/10.1007/s00402-018-3048-0, 2019. 
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Short summary
This study assessed whether the diagnosis and management of fracture-related infections (FRIs) in a low- and middle-income countries (LMICs) currently align with consensus guidelines. We found that two-thirds of cases are managed outside the international guidelines. While the consensus definition is applicable, diagnostic capacity remains limited and microbiological standards are often impractical. Our findings highlight the need to adapt guidelines to local realities and to strengthen capacity in LMICs.
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