Fractures of the distal femur comprise 4 per cent of all femoral fractures. The records of a consecutive series, from 1969 to 1976, of 135 adult patients with 137 fractures, not caused by malignant disease, were reviewed for age, sex, previous disease, type of fracture, treatment and end-result. Eighty-four per cent of the patients were over 50 years of age, 19 per cent had other general factors predisposing them to fracture, and 42 per cent had previous or current disease of the fractured leg. Eight-three fractures were caused by moderate and 52 by severe trauma. Unicondylar fractures were separated into lateral or medial type. Ten fractures were open and 45 were operated on primarily, mostly using condylar plates, screws or Rush pins. Satisfactory results (pain-free knee without angular deformity and at least 90 degrees of motion) were achieved in two-thirds of the fractures following both non-surgical and surgical treatment. However, the surgical group was an average of 8 years younger and contained a higher proportion of bicondylar fractures than the nonsurgical group. Treatment in traction involved a mean period of 7 weeks for 47 patients. This expensive treatment is no longer used for femoral neck, trochanteric or shaft fractures. In distal femoral fractures the goal should also be early mobilization, if necessary using surgical treatment.