KMID : 0386420230360040148
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Journal of the Korean Fracture Society 2023 Volume.36 No. 4 p.148 ~ p.161
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Systematic Diagnosis and Treatment Principles for Acute Fracture-Related Infections
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Choi Jeong-Seok
Kwon Jun-Hyeok Kang Seong-Hyun Kim Young-Youn Choi Won-Seok Oh Jong-Keon Huh Jung-Won
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Abstract
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Acute fracture-related infection (FRI) is a common and serious complication of fracture treatment. The clinical symptoms of the patient and the results of the serological, radiological, and histopathological examinations can be divided into ¡®Confirmatory¡¯ criteria and ¡®Suggestive¡¯ criteria, allowing for the diagnosis of FRI. Treatment principles can be broadly categorized into (1) the DAIR (Debridement, Antimicrobial therapy, Implant Retention) method and (2) the staged reconstruction method. The choice of treatment depends on factors such as the time elapsed after infection, stability of the internal fixation device, reduction status, host physiology, and virulence of the pathogens. Thorough surgical debridement and irrigation, ensuring stability at the fracture site, reconstruction of bone defects, and appropriate soft tissue coverage, along with antibiotic therapy, are essential to suppress or eradicate the infection. The restoration of limb function should be promoted through proper soft tissue coverage and bone union at the fracture site.
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KEYWORD
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Extremities, Fracture, Infection, Diagnosis, Operative surgical procedures
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