Background: Diverse implants for the treatment of supracondylar femoral fractures indirectly reflect the problematic therapeutic approaches of that anatomical region. Different osteosynthetic procedures have been widely used dependent upon the type of fracture, the quality of bone and the surrounding soft tissue. Follow-up studies remain essential to evaluate postoperative results and to optimise surgical therapies continuously. Material & Methods: We retrospectively collected data from 112 patients who underwent surgery for supracondylar femoral fractures between January 1986 and December 1992 and January 1996 and December 1999. Results: According to the AO-classification, there were 23 type-A fractures, 28 type-B fractures, 48 type-C fractures and seven osteoepiphysiolyses (n = 106). Nine patients had condylar osteochondritic lesions of the femur. Non-surgical therapy was applied in five patients (4,5 %). Surgical osteosynthetic therapy included several different procedures. Infections and secondary malfunction proved to be major postoperative complications. The rate of infection was 11,6 %. On average, 46 months after primary surgery clinical and radiological data could be followed up in 54 patients with a proportional number of fractures like in the initial study population. Using the Neer-Score, we showed that 79,6 % of patients had an excellent and good postoperative course, 11,1 % had a moderate and 9,3 % had a bad postoperative course, independent of accompanying co morbidities and multiple injuries. Conclusion: The appropriate choice of implants and following operative guidelines are important prerequisites for the successful treatment of supra- and transcondylar femoral fractures.