Atrium Health Navicent Musculoskeletal Care Orthopedic Trauma

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Understanding Orthopedic Infections

Infection is a common problem throughout medicine, and orthopedics is not any different. Orthopedic infections typically require several surgeries to treat, cure, and recover. Consequently, related financial costs are high, as well as significant psychosocial costs due to the amount of time and effort required for treatment.

Common patient risk factors that associated with higher risk of infections are:

  • Diabetes
  • Immunocompromised conditions
  • Obesity
  • Smoking

Orthopedic Trauma Related Infections

Orthopaedic trauma injuries often involve fractures that break the skin. When this occurs, it is called an open fracture. This is also a significant risk factor towards developing an infection, despite the usual efforts of surgically cleaning the site at time of injury and antibiotics the patient received. Additionally, orthopaedic trauma injuries often are caused by high energy activities, such as a fall from height, motor vehicle collision, or a motor cycle accident. Whether by the dirtiness of the injury, or the severity of the fracture, infection risk is higher than most elective orthopedic surgeries.

Despite the tremendous advancements in medical technology, infection remains a major concern when a surgery of any type is undertaken. This includes the vast array of different types of surgical procedures utilized to address orthopedic traumas.

Preventing Orthopedic Infection

There exist strategies that can be employed to reduce the incidence of orthopedic trauma infection. Patient receive antibiotics before, during, and after the surgical procedure to minimize the risk of infection. After an open fracture, the patient receives antibiotics as soon as possible immediately after the patient arrives to the emergency department. Within 24 hours, and depending on the severity of the open fracture, the patient will be taken to the operating room for a thorough debridement to minimize the risk of infection.

Orthopedic Trauma and MRSA Infections

MRSA infections are becoming an ever-increasing problem in the healthcare community, including these types of infections associated with orthopedic trauma. MRSA, or methicillin-resistant staphylococcus aureus, is a bacterium that is significantly resistant to antibiotics. MRSA infections exist because of the overuse of antibiotics in recent decades. MRSA infection in orthopedic trauma is particularly dangerous to the patient due to infection around the hardware that is implanted in a patient's body.

Orthopaedic trauma infections are unique because they typically involve metal hardware in the area of infection. Hardware can act as a haven for bacteria and cause persistent infection; therefore, surgical care including hardware removal is required to treat these types of infections. Additionally, if the infection develops while the fracture is trying to heal, it typically results in a nonunion of the fracture as well.

Understanding the Risks

Before a person undergoes any type of treatment or procedure, including surgery, he or she must have a clear understanding of possible risks. Infection often times tops the list of risks associated with orthopedic surgical procedures. By having a better understanding of the true nature of the infection risk, and by engaging in a candid conversation with a surgeon, a patient is able to make a well-informed decision about a proposed course of treatment.