Concomitant ipsilateral fractures of the femoral neck and shaft are rare, and present diagnostic difficulties and complex choices as to treatment.

At the Department of Orthopedic surgery, Pusan National University Hospital, from April 1987 to June 1998, 18 cases of the concomitant ipsilateral fractures of the femoral neck and shaft had been treeated and followed up for 48.7 months in average (ranging from 12 months to 89 months). Initially one case of the femoral neck fracture was missed, which was a non-displaced fracture. Femoral reck fractures were treated with multiple screws or pins in all cases except two cases treated with recon struction nail. For the femoral shaft fractures, plate and screws were applied in 12 cases, Ender nails in three cases, reconstruction nail in two cases and skeletal traction in one case. Nonunion of femoral shaft fracture was developed in one case treated with skeletal fraction, metal loosening in one case treated with Ender nails, and limited motion of the knee in three cases which had knee injuries. But in our cases, avascular necrosis of femoral head and nonunion of the femoral neck and metal failure were not developed. The key factors of successful treatment for concomitant ipsilateral fractures of the femoral neck and shaft seemed to be careful evaluation of the associated hip injures in felnoral shaft fracture and early anatomical reduction and rigid fixation of fractures with early motion of joints.