Fracture-related infection (FRI) constitutes a major sequela of orthopaedic trauma care that remains a burden both to the patient and the orthopaedic surgeon. The recommendations by the FRI consensus group serve as a guideline for FRI management, the diagnosis and management of FRI continue to evolve. The general management principles of FRI are multidisciplinary approach (MDT), host optimization, adequate debridement, soft tissue management, dead space management, bone defect management, appropriate use of local and systemic antibiotics, and early rehabilitation. In the era of precision medicine and artificial intelligence, however, it is possible to provide a targeted care to patients with FRI in view of the available surgical options.

There are two major surgical concepts in the management of FRI. The surgical decision depends on several factors which include fracture stability, extent of soft tissue compromise, host factors, causative pathogens, intramedullary nature of implants, and time frame since onset of symptoms. One major limitation of the current surgical approach to the management of FRI is that the decision is dependent on the state of biofilm formation, which is time-dependent. Another major limitation is lack of a clear guideline on which patient benefits from a single-stage surgery or multi-stage surgeries.