Fractures can still unite if the infection is suppressed and for acute infections antibiotic therapy with or without surgical washout may be adequate
Management
For infections present for longer than a few weeks, fracture healing may still be accomplished with antibiotic suppression but the metalwork will need later removal
If the infection cannot be suppressed and becomes too problematic (sepsis, discharging sinus), surgery is required with removal of all implants and debridement of infected bone
For medullary infection from an infected intra‐medullary nail, the medullary canal can be reamed out (cored out with a flexible drill) and a new nail implanted
Alternatively, an external fixator can be applied to give stability with the advantage of some systems of being able to compress the bone ends and gradually lengthen the bone if it has been substantially shortened
This would also be appropriate for infected non‐union of a plate and screw fixation
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