Four elderly patients with a fracture of the distal end of the femur
below a pre-existing non-cemented hip implant were treated with the Zickel
supracondylar device using a closed intramedullary technique. The results
were uniformly successful and there were no complications. This method is
recommended if the fracture is not comminuted and the proximal implant does
not so obstruct the femoral canal as to prevent the passage of the two
intramedullary rods.