Fig. 3.

Radiographs from a 24-year-old male. He was involved in a car accident and had a fractured femur treated with intramedullary nailing. There was post-operative infection. He had three revisions, exchange of nail. fever, ongoing fistulation, cultures revealed Staph. aureus (methicillin sensitive) and Staph. epidermidis (methicillin resistant). a) Post-operative radiograph. An exchange of the intramedullary nail was performed with rigid fixation by locking screws proximally and distally, with defects filled with antibiotic-bone-compound ABC. b) Radiograph at six weeks after surgery. The patient was fully weight-bearing with no sign of infection. c) Radiograph at one year after surgery. Dynamisation was performed by removing the proximal interlocking screws; the patient is fully weight bearing with no signs of infection. d) Radiograph at seven years after surgery. Hardware has been removed. There is complete union and the defects are restored. The patient returned to sports with no signs of infection.