[Osteosynthesis-associated infections : Epidemiology, definition and diagnosis].

摘要: Osteosynthesis-associated infections occur in 1-5% after closed and up to 30% open fractures. There are three different descriptions of implant-associated fracture fixation, which crucial for the selection adequate treatment strategy; temporal appearance from index surgery (early versus late), pathogenesis infection (exogenous, hematogenous contiguous an adjacent focus), duration symptoms (acute chronic). Diagnosis osteosynthesis-associated is challenging, as chronic low-grade often present only with unspecific subtle clinical symptoms. History, evaluation, imaging, histopathlogical microbiological examination build cornerstones diagnostics infections. A new onset rest pain, early loosening prosthesis or mechanically unexplained, nonunion should raise suspicion prompt further evaluation. Percutaneous sinus tracts, purulent wound secretion skin erosions visibility implant confirm infection. Elevated C‑reactive protein value blood a supportive argument infection, but neither sensitive nor specific Imaging plays a key role detect nonunions, infectious callus, sequester, peri-implant osteolysis extraosseous intramedullary involvement. Through histopathological intraoperative tissue samples, well sonication explanted implants causative pathogen identified most cases.