Monolateral rail fixator in paediatric femoral osteomyelitis can be a patient-friendly alternative to conventional fixator.

This case report presents the management of chronic osteomyelitis of femur in a 6-year-old male child, emphasising the role of prophylactic stabilisation using a monolateral rail fixator. The child presented with persistent pus discharge, pain and difficulty in walking following an initial drainage procedure for thigh swelling at another hospital. Clinical, radiological and laboratory findings confirmed the diagnosis of chronic osteomyelitis. During surgery, a large portion of the posterolateral femoral cortex needed to be removed for thorough debridement. To maintain limb stability, a monolateral rail fixator was applied. The patient showed progressive healing on follow-up visits, with restoration of bony architecture and full return to function. The case demonstrates that monolateral rail fixators offer biomechanically superior and a patient-friendly alternative to conventional universal external fixators especially in children. Their use permits early weight bearing and thus better psychosocial outcomes and simplified postoperative care.