Ipsilateral fractures of the femur neck and shaft show diagnostic difficulties and complexity of the treatment. This femoral double fracture, when not initially diagnosed, carries a much high risk of complications, such as aseptic necrosis of the femoral head. Early recognition is of importance. The definitive treatment of a fractured femur should be begun after the ipsilateral hip and the knee joint have been examined clinically and radiologically. At the Department of Orthopedic Surgery, Dae Han General Hospital, from July 1985 to March 1990, four cases of the concomitant ipsilateral femur neck and shaft fracture had been treated and followed-up for 2.4 years in average (ranging from 1.1 to 4.7 years).