Management of Infected Nonunion of Diaphyseal Forearm Fractures

Abstract

Antibiotic therapy plays an essential role in any kind of surgery and has allowed the reduction of post-operative infection enormously. In particular, the orthopedic field has seen a great development of the local antibiotic therapy as adjunct to systemic antibiotic therapy for prophylaxis and treatment. Once microorganism attach to bone, the bacteria become metabolically less active and cover themselves with biofilm, rendering them unresponsive to usual therapeutic antibiotic levels. To achieve pharmacologic kill of bacteria in a biofilm, antibiotic concentration must be from 10 to 100 times higher than the usual bactericidal concentration, which cannot be achieved by safe dose of parenteral antibiotic. In the last decades research has been done towards the possibility of finding the perfect solution for the problem of infected nonunion of forearm fractures.