Successful management of the distal femoral fracture is possible with adherence to the basic principles of anatomic reduction, stable fixation, and early motion. Closed management can achieve these goals in selected patients, but most supracondylar femoral fractures are better treated with operative reconstruction. Implant selection is determined on the basis of the characteristics of the fracture, the bone quality, the needs of the patient, and the experience of the surgeon. Surgical options include the angled blade plate, compression-screw systems, condylar buttress plates, intramedullary nails, external fixation, and modular distal femoral replacement. The author reviews the indications and techniques for using these devices.