Clinical, Radiological, and Functional Outcomes of Custom Threaded Antibiotic-Coated Nails in Osteomyelitis Associated Long Bone Non-Unions: An 8-Month Cohort Study

This prospective cohort study evaluated the effectiveness of custom threaded antibiotic-coated locking nails (TACLNs) for treating osteomyelitis-associated long-bone non-unions in a resource-limited setting with a high burden of multidrug-resistant infections. Thirty adult patients with femoral or tibial non-unions underwent single-stage radical debridement and stabilization using intraoperatively fabricated antibiotic-coated nails. By six months, 96.7% of patients achieved infection control and 90% achieved radiographic union, with significant improvements in inflammatory markers, pain scores, and functional status. Most patients returned to normal activities, and no major implant-related complications or systemic toxicity were observed. Overall, TACLNs appear to be a promising single-stage strategy for managing infected long-bone non-unions, particularly in settings with limited resources and high antimicrobial resistance, although larger multicenter studies with longer follow-up are needed to confirm these findings.