The role of implant retention and conservative management in the management of fracture-related infection

Fracture-related infection (FRI) management has advanced considerably in recent years, offering new possibilities for predictable rates of infection eradication. Debridement, antibiotics, and implant retention (DAIR) procedures have shown promise in the treatment of early FRI. This article provides an overview of the principles and indications of DAIR, including the importance of meticulous debridement and the management of dead space. The outcomes of DAIR are discussed, highlighting the range of fracture union rates reported in the literature. The role of antimicrobial suppression in optimizing host biology and facilitating surgical intervention is also explored. While further research is needed to establish optimal treatment strategies, DAIR offers a valuable treatment approach for FRI when specific criteria are met. Level of evidence: IV.

Automated summary

The management of fracture-related infection (FRI) has advanced in recent years, with debridement, antibiotics, and implant retention (DAIR) procedures showing promise in early FRI treatment. This article discusses the principles and indications of DAIR, emphasizing the importance of meticulous debridement and dead space management. The outcomes of DAIR, including varying fracture union rates, are discussed, as well as the role of antimicrobial suppression. Further research is needed to establish optimal treatment strategies, but DAIR offers valuable treatment for FRI when specific criteria are met.