Segmental bone loss remains a major challenge, often worsened by fracture-related infection (FRI). Surgical debridement and tissue cultures are key initial steps. Bone transport, utilizing distraction osteogenesis, remains a key therapeutic strategy. Innovations like integrated fixation and motorized nails reduce patient morbidity. Management relies on a multidisciplinary approach. This review explores current and emerging concepts in the field of bone transport, focusing on FRI.

Implant-related osteomyelitis is common in orthopedics. Absorbable antibiotic-loaded calcium sulfate (ACS) is an alternative to nonabsorbable antibiotic depot options for osteomyelitis and fracture-related infections. This study aims to evaluate intramedullary canal filling and coating characteristics of ACS around tibial nails using a tibia SAWBONES model. This research was done to better understand the potential utility of ACS in situations requiring fixation in the setting of local infection.

The stoma for transcutaneous osseointegration carries a permanent source of bacterial ingress and infection. The value and role of intraoperative cultures to detect latent bacterial contamination or infection with targeted postoperative antibiotics has not been previously investigated. We compared two cohorts, 8 patients with unexpected positive cultures and 22 patients with negative intraoperative cultures, and found positive cultures do not appear to portend future infectious events.