Abstract: Objective: To discuss the clinical outcome of different internal fixations in treating complex distal femoral fractures.Methods: Forty-five cases of distal femoral fractures were reviewed retrospectively and evaluation of the knee function was made based on the clinical results of different fixations.Results: The fractures of 45 cases healed completely during the follow-up of 6 to 12 months.According to Karlstrom's standard,the excellent rate was 83.3% by dynamic condylar screw,90% by anatomic plate and 42.8% by K-wire plus cancellous screws.Conclusions: Anatomic plate is the best method for treatment of distal femoral fractures and K-wire plus cancellous screws is relatively conservative but efficient for severe open comminuted distal femoral fractures.