This study is testing a new way to prevent infections in people with serious open leg bone fractures (called **tibia fractures**). When a bone breaks, sometimes doctors use a metal rod called an **intramedullary (IM) nail** to help it heal. In this study, some people will get a special IM nail with an **antibiotic coating**. Antibiotics are medicines that fight bacteria and help stop infections. Others will get a regular IM nail. This study will see which one works better.

People who join will be watched for 12 months. Doctors will check on them at the start, then at 6 weeks, 3 months, 6 months, and 12 months. You must be 18 or older and have a serious open tibia fracture to join. You can't join if you're allergic to certain antibiotics, can't speak English or Spanish, are pregnant, or if you can't keep up with the study for a year.

• This study lasts 12 months with several check-ins.
• You must have a severe open tibia fracture to join.
• Some people will receive a special antibiotic-coated nail.