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Infected Osteosynthesis

Infected plates and nail after fracture synthesis


Osteosynthesis is commonly used to fix fractures or osteotomies (procedure in which a bone is cut).


Osteosynthesis hardware include metallic nails, plates, screws, pins, wires, etc..


Although relatively rarely, in approximately 1% to 10%, depending on various factors, the implanted osteosynthesis may become infected during or after surgery.


Infected osteosynthesis is a serious complication and requires early and often combined medico-surgical teatments.


classification and treatment options

The "ICS (Infection, Callus, Stability) classification" of infected osteosyntheis may be useful to drive treatment choice.  Briefly, according to this classification, the following conditions can be found: 


Type I: infection in the presence of a stable osteosynthesis, with callus progression at X-ray examinations. The treatment in these cases may be conservative, controlling the infection with medico-surgical procedures, allowing until bone healing. Hardware removal is then performed after fracture healing.


Type II: presence of infection in a stable osteosynthesis, with scarce or absent callus progression. In those cases, the synthesis can be maintained, controlling the infection as for type I, accelerating bone healing through physical stimulation (low-intensity pulsed ultrasound], pulsed electromagnetic fields, etc.), biological factors (growth factors, bone grafts, etc.) and limited surgical procedures (e.g., dinamization).  


Type III: infection, no callus formation, and unstable osteosynthesis. In these cases, synthesis removal and change of the fixation device are required.




Treatment of infected osteosynthesis is often performed in specialized centers   





Bone and Joint Infections

Galeazzi Institute - Milano - Italy

Bone and Joint Infections


Bone and Joint Infections

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