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Surgical strict asepsis

Although the surgical asepsis is essential for any type of orthopedic case, it is essential in IF. Joints may develop infections by minimal bacterial loads. In addition, there are the effects of the trauma on peri-articular soft tissues and the bone itself, which limits the defensive ability of the joint, and decreases the blood supply both because of the fracture itself and the posterior surgical repair.

Deficiencies in surgical sterility should not be compensated with long-term antibiotics, since intraarticular metallic implants will act as bacteria reservoirs, and therefore infection will occur as soon as the treatment is withdrawn. Additionally, administration of antibiotics or iodine antiseptic agents per intra-articular route is neither recommended since they may trigger chemical synovitis that will difficult the fracture healing process.

Contrarily, the frequent and abundant pressure washing with sterile saline solution is one of the most effective ways to reduce the bacterial load in the joint and clean it of detritus and clots that could harbor infections.

Early mobilization of the joint involved

One of the essential rules in any osteosynthesis is to promote the immediate use of the affected limb, and this is especially true in the post-operatory period of IF. Joints react especially badly to long-term immobilization. Degenerative changes develop rapidly (even within two weeks) [...]

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