Open reduction and internal fixation should be considered for the AO classification type C supracondylar fracture of the femur. However serious complications such as infection and nonunion can occur after extensive stripping of the soft tissue. We will analyze the usefulness of the intramedullary supracondylar nail for treatment of the 1 cases of the difficult supracondylar fracture such as AO type C fracture, nonunion and supracondylar fracture associated with ipsilateral hip fracture. Follow up period of 7 cases was at least 18 months.

1. 5 cases of 7 were AO type C and 2 cases of 7 were associated with ipsilateral hip fracture.

2. 2 cases of 1 rere nonunion and 2 cases of 7 were grade III open fracture in Gustilo classification.

3. 5 cases of 7 had bone union and average range of motion of the knee was 90 degree.

4. There was no infection, but t case was complicated with the femoral shaft fracture near the proximal nail tip, and 2 cases were complicated with the metal failure at the fracture site resulting nonunion.

5. Intramedullary supracondylar nail was very useful tool for the very difficult supracondylar fracture of the femur due to minimal incision, minimal soft tissue dissection and rigid fixation. But this nail was not available for the proximally extended fracture of the femoral shaft.