Implant-related osteomyelitis is common in orthopedics. Absorbable antibiotic-loaded calcium sulfate (ACS) is an alternative to nonabsorbable antibiotic depot options for osteomyelitis and fracture-related infections. This study aims to evaluate intramedullary canal filling and coating characteristics of ACS around tibial nails using a tibia SAWBONES model. This research was done to better understand the potential utility of ACS in situations requiring fixation in the setting of local infection.

We present a case of post-traumatic fracture-related infection with the unusual bacteria Metamycoplasma hominis, usually only seen in people with impaired immune systems. Treatment required multiple surgeries, combined with 10 weeks of treatment with the antibiotics doxycycline and clindamycin. There are no guidelines on treatment, but we recommend a multi-disciplinary team approach, with prolonged antibiotic treatment personalised to the patient based on sensitivities of the organism.