A simple method for fashioning an antibiotic cement-coated interlocking intramedullary nail

Acute or chronic infection in the presence of nonunited fracture or chronic nonunion often necessitates staged surgical treatment. Treatment typically involves removal of hardware, débridement of infected tissue, use of local antibiotic delivery, and a long-term course of intravenous antibiotics. Several methods of local antibiotic delivery using antibiotic-impregnated polymethylmethacrylate (PMMA) have been commonly used, including commercial or hand-fashioned PMMA beads, antibiotic spacers, and antibiotic PMMA-coated guide rods. While these methods address the problem of infection, they do little to address fracture stability. In this report we describe a simple method for fashioning an antibiotic cement-coated interlocking intramedullary nail to treat an infected tibia fracture. This technique capitalizes on local delivery of antibiotics through use of antibiotic cement with the added benefit of improving fracture stability and fixation with an interlocking nail to achieve bony union.