Osteomyelitis is a severe complication of both fracture osteosynthesis and joint replacement surgery [2, 5, 30, 33]. While healthy bone is very resistant to infections, and bacteria alone will not necessarily cause osteomyelitis, other factors such as vascular stasis, soft tissue injuries, fracture instability and the presence of foreign materials are important pathogenetic factors . Fracture instability, caused by inappropriate repair techniques or by implant failure, allows ongoing interfragmentary motion which impairs vascularization and promotes bone necrosis . Fixation devices and prostheses may assist the bacterial colonization, because bacteria produce a mucoid polysaccharide biofilm which binds them to bone and metallic implants and protects them from host defences such as phagocytes and antibodies [2, 9]. Postoperative osteomyelitis is ususally treated by removal of the infected implanted device, surgical debridement of the implant bed and reimplantation of a new device [5, 25]. Antibiotic therapy is also necessary for a successful treatment [5, 25].
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