In the following case, a 20-year-old male was involved in a motorcycle accident where he sustained an open midshaft femur fracture treated with open reduction and internal fixation. Several weeks later, the wound became infected and the plate was removed. Over the following 20 years numerous incision and debridements were performed, with multiple courses of antibiotics for persisting infection. One year following reaming with the reamer-irrigator-aspirator (RIA), the patient is symptom free. It is our belief that organisms were sequestered in the fibrous and bony tissue at the healed fracture site, and, by opening the canal and allowing it to revascularize, the infection was cleared.