Osteomyelitis is one of the most serious infectious complications of the patient undergoing reduction of the fracture by means of synthesis. The standard treatment of the more advanced stages involves the combination of surgical therapy and antibiotics. These infections often do not resolve due to the appearance of antibiotic resistance, the poor ability to permeate the biofilm, or other factors. Bacteriophages are a valuable aid in the treatment of these complex forms.

Clinical picture at the start of treatment with bacteriophages. The patient presents spontaneous pain, and is able to walk with the aid of crutches for short distances. There is an actively secreting fistula and signs of inflammation in the middle and lower third of the leg.

Radiological control one month after the start of therapy. The fistula closed. The X-ray examination demonstrates the formation of callus, prevalent on the side opposite the insertion of the external fixators and the signs of consolidation of the focus of pseudarthrosis.

Clinical picture 40 days after the start of treatment. A fistula secreting a modest amount of serum appears. A culture test shows a staphylococcus, sensitive to a different preparation of bacteriophages (staphylophage®), which is added to the therapy in progress.

Clinical picture at the end of therapy. The means of synthesis have been removed. After a period of 30 days in a cast, the patient walks without the need for any help. At the 3-month follow-up, the skin picture is progressively improving and the callus is progressively ossifying. At 2 years there are no signs of recurrence, neither clinical nor biochemical.