The authors present a series of 26 cases of ipsilateral fractures of the shafts of the femur and tibia treated by internal fixation. Twenty have been followed up for more than 2 years. Thirteen healed without incident and achieved excellent function. Six others regained a similar level of mobility after complications had been treated. The early surgical stabilisation of such fractures is advocated, allowing recognition of simultaneous injuries to ligaments of the knee.