Management of a case of infected non-union tibia with IMIL Nail in-situ by antibiotic exchange nailing

Abstract

Long bone infection-related non-union is a chronic and disabling condition. Whenever the implants used during the internal-fixation which gradually develops into a potential infection medium due to adherence of bacterial and formation of biofilm which becomes more challenging. This study reports the effectiveness of antibiotic cement-coated IMIL nailing in treating infected nonunion tibia in terms of infection control and bone union. A 22-year-old man came with the discharging sinuses with infected non-union tibia including a nail in-situ. Patient was treated with antibiotic cement coated nailing. After 3 months of primary nailing, the patient was admitted for antibiotic nailing exchange. Pre - operative cultures for staphylococcus aureus were positive, indicating clinical infection. After wound healing and suture removal, the patient was discharged after antibiotic nailing. For six months, the patient was monitored and treated on a regular basis. Within three weeks, the infection was cleared, and after three months of antibiotic exchange nailing, the bones had joined. To accomplish infection control and bone union, antibiotic cemented nailing was the only treatment needed. For the treatment of infected tibial nonunion, antibiotic cement coated nailing is a convenient, affordable, and rapid single-stage method.