From August 1992 to January 1995, 24 patients with 26 supracondylar femoral fractures were treated with a retrograde intramedullary nail. There were 22 patients with 24 nails available for review. Eight fractures were open and 13 were intraarticular fractures. There were a significant number of associated injuries. The average followup interval was 18 months (range, 4-36 months). All fractures healed by 4 months, (average, 3 months). Only 1 patient required bone grafting. There were no implant failures or superficial or deep infections. One malunion occurred. Average knee range of motion was 104 degrees. A previously described rating scale was used to evaluate function. There were 4 excellent, 16 good, 2 fair, and 2 poor results. The supracondylar nail provides rigid internal fixation for rapid healing and comparable functional outcomes to lateral fixation devices with significantly less soft tissue dissection.