Intramedullary nails (IM nails) are metal rods inserted into the intramedullary cavity to treat fractures of long bones. Intramedullary nailing of long-bone shaft fractures is generally accepted as a standard treatment for many such fractures. An image of an IM nail fixing a tibial fracture is shown below. The IM nail offers stabilisation of the fracture and enables the fracture to heal rapidly, without requiring a plaster cast as may have been used in the past.
Infection of an IM nail is a serious complication requiring revision surgery to treat the infection locally or even remove the nail, or the use of alternative implants such as an external fixator to allow the fracture to heal, prolonging the hospital stay. Prevention of infection of IM nails usually involves preoperative antibiotic administration. The BALI project would supplement this prophylaxis by providing an additional antimicrobial agent at the site of the implant.
The figure below this article shows an intramedullary nail that is fixing a midshaft tibial fracture. Copyright by AO Foundation, Switzerland. Source: AO Surgery Reference, www.aosurgery.org