Infection in fracture fixation: Device design and antibiotic coatings reduce infection rates

Abstract

Musculoskeletal infection is one of the most common complications associated with surgical fixation of bones fractured during trauma. Severe fractures with extensive tissue damage are particularly prone to infection due to the high risk of wound contamination and compromised vascularity in the affected tissues. An infection associated with a fracture fixation device can delay healing, greatly increase patient morbidity, require multiple surgeries for effective treatment outcomes, and may tremendously increase treatment costs. In the following chapter, two approaches to reduce the incidence of infection associated with fracture fixation devices will be described. The first is a passive approach involving aspects of implant design and application, whereby the implant used and the techniques used to place them can influence resistance to infection, at least in animal studies. The second approach involves antibiotic-coated intramedullary nails with a focus on two different gentamicin coatings.