Unicondylar fractures of the femur on osteosynthesis equipment are a particular entity in terms of the lesion mechanisms and therapeutic difficulties. We report this case because of its exceptional nature and discuss the mechanism of occurrence. It was a lateral sagittal unicondylar fracture of the femur on a nail of Küntscher that had been laid for medio-diaphyseal fracture. The causal mechanism was direct. A double screwing on each side of the nail after an open reduction followed by an early rehabilitation was carried out. Consolidation was obtained at 3 months and the nail removed at 18 months with a good functional knee result. Anatomical reduction and fixation allowing early rehabilitation represent a guarantee for a good long-term result.
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