Abstract
1. Seven cases of infection following medullary nailing of the femur have been studied.
2. Points in the diagnosis of nail track infection are emphasised, especially periosteal reaction.
3. It is felt that a sinograph is an essential part of the investigation and can be useful to assess progress.
4. The principles of treatment of established nail track infection are: adequate drainage of the fracture site; dependent drainage of the whole track by draining the pocket at the lower end; the use of instillation tubes to irrigate the nail track with antibiotics. Once the fracture is stable and the nail track adequately treated by local and general antibiotics the nail should be removed. It is not considered necessary to wait for bony union before removal of the nail.
