
Two levels of certainty around diagnostic features were defined. The outcome of this process led to a consensus definition of FRI. As a final step, a consensus meeting was held with an expert panel. Approximately 90% of the more than 2000 surgeons who responded suggested that a definition of FRI is required. In response to this conclusion, an international survey on the need for and key components of a definition of FRI was distributed amongst all registered AOTrauma users. The process that led to this proposed definition started with a systematic literature review, which revealed that the majority of randomized controlled trials in fracture care do not use a standardized definition of FRI. In order to address this issue, an expert group comprised of a number of scientific and medical organizations has been convened, with the support of the AO Foundation, in order to develop a consensus definition. The absence of a working definition of FRI renders existing studies difficult to evaluate or compare. Accurately estimating the impact of this complication has been hampered by the lack of a clear definition.

8 Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Switzerland.

7 Medical University Basel, Switzerland.6 Department of Osteoarticular Pathology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, United Kingdom.5 Department of Orthopaedic Surgery, University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom.4 AO Research Institute Davos, Davos, Switzerland.3 The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, United Kingdom.Electronic address: 2 Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Switzerland.

1 Department of Trauma Surgery, University Hospitals Leuven, Belgium KU Leuven - University of Leuven, Department Development and Regeneration, B-3000 Leuven, Belgium.
