Detection of Infection Following an Open Tibial Fracture via Synovial Alpha-defensins

Fracture-related infections are challenging complications following the fixation of open fractures. Because of commonly used surgical approaches used for intramedullary nailing, the knee joint is also susceptible to infection following fixation, either as a complication of the surgical approach itself or due to the communication of the joint space with intramedullary implants placed through the joint. This is a case report of an early postoperative knee joint sepsis following suprapatellar nailing of an open tibia fracture where the joint infection was differentiated from postoperative effusion by the use of alpha-defensin testing. The follow-on treatment addressed the infection identified in the joint as well as exchanged nailing with an antibiotic-coated nail to protect the fracture.