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Hypothesis: To determine whether retrograde nailing of distal femoral fractures is beneficial for the elderly patient. Methods: Prospective study of consecutive patients, aged sixty-five years or older, whose distal femoral fractures were treated with a retrograde femoral nail between January 3, , and April 30, Results: Twenty-four of twenty-six patients were followed for more than twelve months.

Twenty-three were closed. There was one Gustilo type 1 fracture. All fractures healed. Six patients did not walk before injury. Using the Neer scoring system, there were ten 56 percent excellent 85 or more points , six 33 percent good 70 or more points , and two 11 percent fair 55 or more points results; none of the cases were considered as failures less than 55 points.

Conclusions: Retrograde intramedullary nailing makes possible a biological osteosynthesis of distal femoral fractures. It also produces good functional results in elderly patients. The two major technical problems encountered with this implant are the poor hold of the distal interlocking screws and difficulties with proximal interlocking.

Early weight-bearing is not advisable. Abstract Hypothesis: To determine whether retrograde nailing of distal femoral fractures is beneficial for the elderly patient.