Salvage of Infected Dynamic Hip Screw and Distal Femur Nail Fixation for Ipsilateral Femoral Neck and Femoral Shaft Fracture Using Antibiotic-Coated Custom Long-Stem Austin Moore Prosthesis – A Rare Case Report

Introduction: Ipsilateral femoral neck and shaft fractures are rare injuries (2-10%), typically resulting from high-energy trauma. Dual fixation using a dynamic hip screw (DHS) and distal femoral nailing (DFN) is standard; however, deep infection following such fixation presents a major therapeutic challenge. Case Report: We report a case of a middle-aged male with an ipsilateral femoral neck and shaft fracture managed initially with DHS and DFN. The post-operative course was complicated by chronic deep infection with persistent sinus and implant loosening despite repeated debridement and antibiotic therapy. Management and Outcome: The patient underwent implant removal, radical debridement, and reconstruction using a long-stem antibiotic-coated custom-made Austin Moore prosthesis. At 2-year follow-up, the patient was infection-free, pain-free, ambulatory without support, and demonstrated satisfactory functional outcome as assessed by Harris Hip Score. Conclusion: A custom long-stem antibiotic-coated Austin Moore prosthesis may serve as a feasible single-stage salvage option in selected cases of infected dual femoral fixation. However, further studies are required to validate its reproducibility and long-term outcomes.