ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Systematic investigation and comparison of diagnostic methods in implant-related infections and infectious non-unions in trauma surgery- results of a prospective study.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Sonication versus peri-implant tissue culture in fracture-related infection: diagnostic performance and therapeutic consequences in a single-center cohort.Journal of bone and joint infection · 2026Article
- The Significance of Sonication in the Detection of Peri-Implant Infections.Antibiotics (Basel, Switzerland) · 2026Article
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8 authors.
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Abstract
purposeAlongside surgical therapy, the successful treatment of infection-related nonunion depends on the accurate identification of pathogens so as to ensure targeted anti-infective treatment. The available diagnostic methods continue to exhibit low sensitivity. The aim of the study was to determine the most sensitive method for the accurate diagnosis of infection-related nonunion by comparing sonication with other diagnostic procedures.
methodsIn a prospective comparative study, 100 patients with nonunions (study group, SG) and 100 patients with planned metal removal (control group, CG) were compared. The diagnostic methods employed included standard culture, enrichment in blood culture bottles after tissue homogenization, sonication with and without membrane filtration, and histopathology. Sensitivity, specificity, and predictive values were calculated.
resultsIn 133 patients (SG n = 73; CG n = 60), at least one sample was tested positive for a bacterium. Infection was diagnosed in 72 patients (SG n = 45; CG n = 27). Coagulase-negative staphylococci and Cutibacterium acnes were the most frequently detected pathogens. Sonication achieved the highest sensitivity (80.6%) for detecting an infection but there was no significant difference as compared to the other methods. The combination of standard culture and sonication yielded the greatest overall sensitivity (97.2%), whereas the combination of tissue homogenization and histology achieved the best results for specificity (89.1%) and predictive values (82.3%).
conclusionA high rate of pathogen detection was observed in clinically inapparent nonunions. Sonication was not clearly superior in our setting. In general, the combination of several diagnostic methods provided the most informative results. Therefore, sonication and tissue homogenization can both be considered useful additions to standard cultures.
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