Revision proximal femoral antibiotic nailing for non-union of neck and shaft of femur fracture with infected implant in situ and discharging sinuses: A case report

Abstract

Introduction: Chronic osteomyelitis of femur with implant in-situ and discharging sinuses is conventionally treated stepwise, but our study is more economical and effective single step procedure of fracture fixation by using antibiotic intramedullary nails, and antibiotic beads done in same sitting. Aim: To assess the duration of eradication of infections. and to determine duration of bony union for cases treated secondarily with antibiotic intramedullary nail. Material and Methods: This is the case report of chronic osteomyelitis of femur with implant in-situ with discharging sinuses. The case was primarily treated immediately after trauma with plating and screw fixation now presented with infection and discharging sinuses. Culture and sensitivity were done, allergy for the sensitive antibiotics ruled out. Postoperatively it was followed up for 12 months. Results: Infection was fully controlled and bony union was achieved. Discussion: Antibiotic nailing is comparatively more economical and effective single stage procedure for management of infected femur fracture with non-union with implant in-situ with discharging sinuses. This method delivers high concentration of antibiotic at local site without any systemic toxicity. It has better compliance compared to the conventional way of management.