Alt et al reported a classification of fracture-related infections called FRI. This specifies a number of factors that impact management and outcome. The authors are from multiple institutions in Europe, the United States and South Africa.
Parameters:
(1) fracture (F)
(2) relevant patient factors (R)
(3) impairment of soft tissues (I)
Parameter
Finding
Designation
fracture
fracture healed
1
fracture not healed with good bone healing potential
2
fracture not healed with poor bone healing potential
3
fracture not healed with major bone defect (reconstruction possible)
4
fracture not healed and bone reconstruction is not possible
5
relevant patient factors
fit for surgery
1
1 or 2 systemic comorbidities without end-organ damage
2
>= 3 systemic comorbidities without end-organ damage
3
systemic comorbidity with end-organ damage
4
unfit for surgery OR declines treatment
5
impairment of soft tissues
robust direct wound closure possible
1
direct wound closure possible but cover of bone and/or implant fragile
2
soft tissue reconstruction is required with local tissue transfer
3
soft tissue reconstruction is required with free tissue transfer
4
soft tissue reconstruction not possible
5
Designation
Color Code
Relevance
1
dark green
good
2
light green
fair
3
yellow
warning
4
orange
caution
5
red
poor
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