We describe two case reports of supracondylar nail failure in young patient
s who had sustained high energy, closed, comminuted supracondylar femoral f
ractures. These injuries had been successfully treated using retrograde int
ramedullary nails which failed several months later because of excessive ac
tivity on the part of the patient without the presence of full flexion at t
he knee. The failed implants were removed and dynamic condylar screws were
inserted with bone graft to the fracture site. This revision procedure prod
uced solid bony union. We recommend that these patients should not fully we
ight bear, or engage in strenuous physiotherapy after nailing, until the fr
acture has consolidated and a functional range of knee motion has been obta
ined. Failed implants should be managed by nail removal, bone grafting and
insertion of a dynamic condylar screw.