This study aimed to compare the efficacy of two treatment modalities for periprosthetic supracondylar fractures. The results of intramedullary nailing in 7 patients and locked plating in 9 patients were reviewed retrospectively. Mean follow-up was 4.3 years (range : 1 to 13 years). One patient died on the first postoperative day. Union of the fracture was achieved in the other 15 patients, after a mean time of 3.86 months: 3.9 months (range: 3 to 6 months) in the locked plate group and 3.86 months (range : 3 to 5 months) in the intramedullary nail group (p = 0.96). Mean Knee Society Score was 78 points (range : 68 to 84 points) and mean total knee range of motion was 82 degrees (range 70 degrees to 90 degrees) with no significant differences between groups. Sagittal and coronal plane measurements were similar both in the early postoperative period and at the last follow-up. The two treatment modalities had similar results with a high success rate.