PURPOSE: Searching for the most excellent outcome of ipsilateral fractures of femur and tibia according to the treatment methods and the combined injuries which occasionally neglected. MATERIALS AND METHODS: We reviewed thirty cases of ipsilateral fractures of the femur and tibia, treated at the orthopaedic department of the Dong-A university hospital between February 1991 and May 1999. Children under 10 years old, treated by conservative methods were excluded in this study. Average follow-up period was 23.2 months(range, 5 to 44 months) and mean age was 34.7 years old(range, 16 to 58 years). RESULTS: According to the measurement of the Karlstrom and Olerud, range of motion of the ipsilateral knee joint and bony union time, intramedullary nailing was the treatment of choice for both femur and tibia fracures except limited by open wound and fracture level and types(14 cases, 47%). The ipsilateral knee ligaments injury was the most common combined injury which neglected at initial trauma(8 cases, 27%). CONCLUSION: By intramedullary nailing, the patients with ipsilateral fractures of femur and tibia could achieve early weight bearing ambulation and ipsilateral knee joint excercise, and showed the most excellent outcome. After fixation of both femur and tibia fractures, by physical examination and arthroscopic examination of ipsilateral knee joint we could detect and treat the ipsilateral knee ligaments injuries, which occasionally neglected.