Infection associated with orthopaedic fixation devices are suspected on clinical and radiological findings, and confirmed by microbiological studies. Antimicrobial therapy should be avoided before tissues sampling for culture. The goals of treatment are consolidation of fracture and preservation of chronic osteomyelitis. Retention of the internal fixation device combined with long-term antibiotic treatment is only reasonable in some acute cases (if the implant is stable). In other cases, implant should be removed, replaced by an external fixator. Secondary, bone and soft tissues reconstruction could be done. Antimicrobial treatment according to the pathogen and its antimicrobial susceptibility is administered for 6 to 12 weeks. Long-term prognosis is good but with some long-term resurgences.