Distal femur fractures can affect both young and elderly patients. Concomitant injuries including vascular injury and knee dislocations must be identified early. Distal femur fractures tend to be treated surgically with fixed angle locking plates and retrograde intramedullary nails but can be challenging with prior ipsilateral knee or hip replacements. Outcomes are generally promising, but complications with bone healing, pain, and stiffness can occur.