Articles | Volume 8, issue 2
https://doi.org/10.5194/jbji-8-133-2023
https://doi.org/10.5194/jbji-8-133-2023
Original full-length article
 | 
21 Apr 2023
Original full-length article |  | 21 Apr 2023

Diagnosis of fracture-related infection in patients without clinical confirmatory criteria: an international retrospective cohort study

Niels Vanvelk, Esther M. M. Van Lieshout, Jolien Onsea, Jonathan Sliepen, Geertje Govaert, Frank F. A. IJpma, Melissa Depypere, Jamie Ferguson, Martin McNally, William T. Obremskey, Charalampos Zalavras, Michael H. J. Verhofstad, and Willem-Jan Metsemakers

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Cited articles

Bosch, P., Glaudemans, A. W. J. M., de Vries, J.-P. P. M., Middelberg, T. R., Govaert, G. A. M., and IJpma, F. F. A.: Nuclear imaging for diagnosing fracture-related infection, Clinical and Translational Imaging, 8, 289–298, https://doi.org/10.1007/s40336-020-00374-0, 2020. 
Depypere, M., Kuehl, R., Metsemakers, W. J., Senneville, E., McNally, M. A., Obremskey, W. T., Zimmerli, W., Atkins, B. L., Trampuz, A., and Fracture-Related Infection Consensus, G.: Recommendations for Systemic Antimicrobial Therapy in Fracture-Related Infection: A Consensus From an International Expert Group, J. Orthop. Trauma, 34, 30–41, https://doi.org/10.1097/BOT.0000000000001626, 2020. 
Depypere, M., Sliepen, J., Onsea, J., Debaveye, Y., Govaert, G. A. M., IJpma, F. F. A., Zimmerli, W., and Metsemakers, W. J.: The Microbiological Etiology of Fracture-Related Infection, Front. Cell Infect. Mi., 12, 934485, https://doi.org/10.3389/fcimb.2022.934485, 2022. 
Dudareva, M., Barrett, L., Figtree, M., Scarborough, M., Watanabe, M., Newnham, R., Wallis, R., Oakley, S., Kendrick, B., Stubbs, D., McNally, M. A., Bejon, P., Atkins, B. A., Taylor, A., and Brent, A. J.: Sonication versus Tissue Sampling for Diagnosis of Prosthetic Joint and Other Orthopedic Device-Related Infections, J. Clin. Microbiol., 56, e00688-18, https://doi.org/10.1128/jcm.00688-18, 2018. 
Dudareva, M., Barrett, L. K., Morgenstern, M., Atkins, B. L., Brent, A. J., and McNally, M. A.: Providing an Evidence Base for Tissue Sampling and Culture Interpretation in Suspected Fracture-Related Infection, J. Bone Joint Surg. Am., 103, 977–983, https://doi.org/10.2106/jbjs.20.00409, 2021. 
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Short summary
This international retrospective cohort study displays the diagnostic characteristics of 609 patients who were treated for fracture-related infection (FRI). Clinical confirmatory criteria were present in 77% of patients. In the remaining patients, the decision to operatively collect deep tissue cultures had to be based on a set of suggestive criteria. The combined use of these suggestive criteria should guide treating physicians in the management pathway of FRI.