Biomechanical stability in fracture treatment and its relationship with infections
Keywords:
biomechanical stability, absolute stability, relative stability, infectionAbstract
Introduction: Biomechanical stability of the fracture site is a vital factor for bone healing, as it allows the formation of the callus that joins the ends of the fracture and allows loads to be transmitted through it. Infection associated with these traumas is considered a musculoskeletal complication in orthopedic trauma surgery.
Objective: To review the scientific advances related to biomechanical stability in fracture consolidation and its relationship with infections.
Methods: A retrospective review was made of the scientific advances related to biomechanical stability in fracture consolidation and its relationship with infection. Emphasis was placed on the factors that intervene in this process.
Development: Current principles in fracture treatment recognize two forms of biomechanical stability to obtain consolidation: absolute stability and relative stability. During indirect bone healing, tension is required between a minimum required for callus induction and a maximum necessary for bone bridge formation. The development of an infection depends on the health status of the patient (host) and the amount of germs in the surgical wound. Local conditions of the postoperative area (inflammatory transudate, hematoma, remaining necrotic tissue) can act as biological incubator and favor microbial virulence, which triggers infection.
Conclusions: Biomechanical stability is essential for fracture healing. The principles of osteosynthesis and the characteristics of the fracture to be treated must be respected when making surgical decisions. The existence of vicious circle between instability and infection is reflected in the evolution of tissue trauma, local inflammation, interrupted neovascularity and osteolysis; therefore, stability can prevent and treat infection.
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