Introduction: Femoral shaft fractures account for 1.6% of all paediatric bony injuries. Angulation, malrotation and shortening are not always corrected effectively by conservative methods. Fixation of femur fractures in children & adolescents by flexible intramedullary nailing is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of in hospital traction and spica cast care. Method: A prospective study of 90 cases of fracture shaft femur was done in BMCRI from 2009 to 2011 Children and adolescents between the age group of 5-15 years with femoral shaft fractures excluding subtrochanteric and supracondylar fractures were included. All patients underwent titanium elastic nailing fixation for the femur fracture. Clinical parameters like pain, comfort to the patients, early mobilization, operative technique, radiological evaluation for union, stages of weight bearing till complete recovery and any associated complications were studied. Patients were followed up for a period of 6 months at 4,8,12 and 24 weeks after surgery. Result: The outcome was excellent in 70 cases, satisfactory in 20 cases and there were no cases of poor outcome. No cases got infected, 2 cases had valgus malunion and 15 cases had limb lengthening. Conclusion:  Flexible intramedullary nail leads to rapid fracture union by preservation of fracture hematoma and limited soft tissue exposure. It also helps in preventing damage to the physis, is fairly a simple, reliable technique with a shorter learning curve with negligible complications. 

Keywords: Paediatrics; TENS; Femoral diaphyseal fractures.