Osteosynthesis implant infections: A series of 5 cases

Despite some major advancements in surgery and advances in antibiotic prophylaxis, orthopedic implant infections remain a large concern, with reported rates of 0.5% to 2% in closed fractures and even more than 30% for open fractures. The true prevalence is likely underappreciated because of diagnostic hurdles. This is a report of patients treated in our surgical intensive care unit for two months. We assessed five young polytraumatized patients (22 to 36 years; four men, one woman) with early-onset postoperative infections involving osteosynthesis. Clinical, biological, microbiological, radiological, and therapeutic details were retrieved from medical records. Microbiological cultures demonstrated polymicrobial infections with Staphylococcus aureus as well as multidrug-resistant Gram-negative bacilli. Three patients had disastrous outcomes, including two cases of dying from infections and one with amputation of a limb; the other two had a favorable clinical course. These findings underscore the persisting severity of infections associated with implant placement in young, severely injured patients. Multidrug-resistant organisms and biofilm formation are highly prevalent and create many difficulties for conventional therapies that require early diagnosis and personalized surgical interventions. Moreover, treatment of these infections will need a personalized approach guided by an adaptive and personalized treatment approach that will guide modern molecular diagnostics and multidisciplinary care protocols; this will ensure full clinical effectiveness. This example series highlights an underrepresented issue and lethal danger of orthopedic implant infections, regardless of the best surgical or prophylactic environment. It focuses on surveillance and intense early intervention, ongoing surveillance, intense early treatment, and the quest for new solutions to counteract the formation of resistant biofilms. All in all, implant infections are a serious underlying complication that will go largely unnoticed. They must be treated by keeping attention and care personalized so as not to have catastrophic consequences for their devastating functional or even fatal ramifications.