Over a 10 year period, 6 patients were treated for ipsilateral hip and femoral shaft fractures. All resulted from traffic accidents and had associated injuries. All the hip fractures were femoral neck fractures. All the femure shaft fractures were at the midshaft and the majority of them sowed marked comminution. There were no missed diagnosis of hip fractures by routine pelvis x-ray in patients with lower limb fractures. Femur neck fractures were treated with screw or pin fixation in 3 cases and fibular graft and cancellous screwing in 2 cases;one basocervical fracture was treated with Jewett nailing. For the shaft fractures, plate and screw were applied in 3 cases and intramedullary nailing in 2 cases;1 case of severe comminution was treated conservatively. In contrast to the severity of the trauma, the results were relatively good in cases of fractures treated with internal fixation. Major complieation was limited range of knee motion in the case treated with traction for one of the two fractures. The key of successful treatment for this high-energy trauma, which presents complex choices as to treatment, seemed to be not missing of hip fracture and to require rigid fixation of both fractures surgically.