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We present our experience with a retrograde supracondylar nail used for the management of fractures of the distal femur in elderly patients. Eighteen fractures of the distal femur in 18 patients were treated with AIM titanium supracondylar nails. Sixteen patients with a median age of 83 years (62–100 years) were finally available for review. All 16 fractures were classified as extra-articular type A according to the AO classification. The average operative time was 58 min. Follow up ranged between 4 and 35 months (average 20.4 months). Fifteen fractures (93.7%) united in an average duration of 3.6 months. The average range of motion achieved at the knee was 100.6°. There were no implant failures, knee sepsis or wound healing problems. One non-union and two stress fractures of the femur above the nail were the main complications in this series. We concluded that the AIM titanium supracondylar nail is a useful …