Supracondylar femur fractures with segmental defects can be difficult fractures to treat. When associated with open wounds, these injuries can be associated with numerous complications including nonunion, malunion, infection, and arthrofibrosis. In this article, we review our algorithm for treating these fractures and highlight critical aspects of the process which differs from previous techniques described. We feel that this technique has specific benefits that mitigate infection risk and minimize additional soft-tissue insult without compromising stability. Our results demonstrate good postoperative knee range of motion, a high union rate, with low complication rates.