The segmental fracture of the femur usually was caused by severe force and often accompanied with marked damage of the soft tissue and associated fractures of the other bones. Treatment of the segmental fracture is almost always required operation, and the interest lies in deciding on what operating methods to use and the technical difficulty involed with each method.

From Jan. 1986 to Dec. 1993, 29 patients were treated for femoral neck or intertrochanteric fractures which accompanied with ipsilateral femoral shaft fractures at Severance Hospital, Yonsei University College of Medicine, 16 cases were intracapsular (femoral neck) and 13 cases were extracapsular (intertrochanter) hip fractures. We analysed the union time and complications of the 21 cases which were followed over one year. The following results were obtained:

1. For the group of ipsilateral femoral neck and shaft fracture, the knee injury was the most common associated injury (66.7%).

2. For the group of ipsilateral intertrochanter and femoral shaft fracture, the knee injury was not so frequent than the previous group (11.1 to).

3. The ipsilateral femoral neck and shaft fracture was induced by a longitudinal force, which was parallel with femoral shaft and through the knee, and accompanied with a lateral force. But the ipsilateral intertrochanter and femoral shaft fracture may be induced by a different mechanism, a direct transverse force towards the proximal femur.

In conclusion. the ipsilateral intertrochanteric and femoral shaft fracture should be distinguished from the ipsilateral femoral neck and shaft fracture, because of the associated injury pattern and different mechanism of the injury.