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Biomaterials Associated Infection pp 435–453Cite as

Infection in Fracture Fixation: Device Design and Antibiotic Coatings Reduce Infection Rates

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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.

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Authors and Affiliations

  1. Department of Orthopedics, Research Center for Experimental Orthopedics, Trauma Surgery and Paraplegiology, Heidelberg University Hospital, Heidelberg, Germany

    Gerhard Schmidmaier

  2. AO Research Institute Davos, Clavadelerstrasse 9, Davos Platz, Switzerland

    Abhay D. Gahukamble, T. Fintan Moriarty & R. Geoff Richards

Authors
  1. Gerhard Schmidmaier
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  2. Abhay D. Gahukamble
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  3. T. Fintan Moriarty
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  4. R. Geoff Richards
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Corresponding author

Correspondence to Gerhard Schmidmaier .

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Editors and Affiliations

  1. AO Research Institute Davos, Clavadelerstrasse 8, Davos Platz, 7270, Switzerland

    T. Fintan Moriarty

  2. , Medical Microbiology, Academic Medical Center, Meibergdreef 15, Amsterdam, 1105 AZ, Netherlands

    Sebastian A.J. Zaat

  3. University Medical Center Groningen, A. Deusinglaan 1, Groningen, 9713 AV, Netherlands

    Henk J. Busscher

Glossary

Biological internal fixation

A technique of careful surgical exposure, fracture reduction, and fixation, which favors the preservation of the blood supply of the fracture site and, thereby, optimizes the healing potential of the bone and soft tissues.

Dynamic compression plate (DCP)

A plate through which screws can be inserted to provide compression across a fracture site.

External fixation

Skeletal stabilization using pins, wires, or screws that protrude through the skin and are linked externally by bars or other devices.

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Schmidmaier, G., Gahukamble, A.D., Moriarty, T.F., Richards, R.G. (2013). Infection in Fracture Fixation: Device Design and Antibiotic Coatings Reduce Infection Rates. In: Moriarty, T., Zaat, S., Busscher, H. (eds) Biomaterials Associated Infection. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1031-7_17

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