Treatment of interprosthetic fracture of distal femur around total knee replacement is difficult. Preexisting hip implants further increase the technical challenges. In this case report, we present an 85-year-old patient who suffered from a displaced distal femur fracture with a pre-existing dynamic condylar screw and total knee replacement. Internal fixation with distal femur locking plate and incorporation of the locking plate with the pre-existing dynamic condylar screw provided a good treatment option for this difficult problem. It avoided the possible complication associated with removal of pre-existing implant and allowed sufficient overlap of the two plates to prevent any stress risers or fracture.
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