Managing nonunions and fracture-related infections: a quarter century of knowledge, and still curious : a narrative review

Nonunions and fracture-related infections represent a significant complication in orthopedic and trauma care, with their incidence rising due to an aging, more comorbid global population and the escalating threat of multi-resistant pathogens. This narrative review highlights pivotal advancements in...

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Hauptverfasser: Armbruster, Jonas (VerfasserIn) , Thomas, Benjamin (VerfasserIn) , Stengel, Dirk (VerfasserIn) , Spranger, Nikolai (VerfasserIn) , Grützner, Paul Alfred (VerfasserIn) , Hackl, Simon (VerfasserIn)
Dokumenttyp: Rezension
Sprache:Englisch
Veröffentlicht: 1 November 2025
In: Journal of Clinical Medicine
Year: 2025, Jahrgang: 14, Heft: 21, Pages: 1-21
ISSN:2077-0383
DOI:10.3390/jcm14217767
Schlagworte:
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm14217767
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/14/21/7767
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Verfasserangaben:Jonas Armbruster, Benjamin Thomas, Dirk Stengel, Nikolai Spranger, Paul Alfred Gruetzner and Simon Hackl

MARC

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520 |a Nonunions and fracture-related infections represent a significant complication in orthopedic and trauma care, with their incidence rising due to an aging, more comorbid global population and the escalating threat of multi-resistant pathogens. This narrative review highlights pivotal advancements in diagnostics and therapeutic approaches, while also providing an outlook on future directions. Diagnostic methodologies have significantly evolved from traditional cultures to sophisticated molecular techniques like metagenomic next-generation sequencing and advanced imaging. Simultaneously, therapeutic strategies have undergone substantial refinement, encompassing orthoplastic management for infected open fractures and the innovative application of antibiotic-loaded bone substitutes for local drug delivery. The effective integration of these possibilities into daily patient care critically depends on specialized centers. These institutions play an indispensable role in managing complex cases and fostering innovation. Despite considerable progress over the past 25 years, ongoing research, interdisciplinary collaboration, and a steadfast commitment to evidence-based practice remain crucial to transforming management for the future. 
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