58 years old lady with multiple medical co-morbidities sustained fracture of distal femur with intramuscular extension which was treated by Open Reduction Interlock Femur with Plate but fracture did not unite and she was unable to walk and load the limb. We did two stage surgery. In 1st stage plate was removed and in 2nd stage Total Knee Replacement was done using mega prosthesis. Achieving union in these patient is challenge therefore it is better to remove these ununited fragment and replace them with prosthesis. This procedure is surgically challenging and very few center in India do it. Post operatively patient is comfortable and walking with walker.
