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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.

Introduction: Wound infection is a highly prevalent complication in open fractures. Institution of antibiotics early have come across as a beneficial factor in reducing the infection rate thereby enabling faster rehabilitation. In this study we have observed the impact of delayed initiation of antibiotics in wound infection in open injury cases. Materials and Methods: A retrospective observational study including patients in the age group of 18 to 55 years with open fractures managed between January 2018 to August 2019. About sixty patients with open fractures were included in this study. Patients were grouped based on the Gustilo-Anderson system of classification of open fracture. From the hospital medical records the approximate time interval between the administration of antibiotics and time of injury were calculated. Majority of participants belonged to fracture type III B (31.58%) under Gustilo-Anderson classification.Results: The proportions of fracture grade I, II, IIIA, III C were 21.05%, 3.51%, 29.82%, 14.04% respectively. Among the 43 patients who received intravenous antibiotics (71.67%) within six hours of trauma only 8 had recorded wound infections. Remaining 17 patients received antibiotics later than 6 hours (28.33%) of which 7 (41%) developed wound infection. Open injuries classified under high grades of Gustilo-Anderson showed greater incidence of wound infection. Conclusion:We conclude that early administration of appropriate antibiotics is crucial to minimise the infection risk in open fractures.