Ispilateral knee synovitis and pain after femoral shaft fracture and osteosynthesis were studied in 73 patients, 11 females and 62 males. All had isolated closed fractures of the femoral shaft without direct injury to the knee. Synovitis was found in 12 patients (16.4%) and 9 patients (12.3%) had significant knee pain which retarded rehabilitation of knee function. The synovitis and pain related to the severity of injury and surgical approach. This condition should be prevented in order to promote recovery of such patients.