INTRODUCTION: Titanium elastic nails are used to treat femur shaft fractures in paediatric patients. This method is minimally invasive and does not cause epiphyseal injury or impairment of femoral head blood supply.

OBJECTIVES: The objective is to evaluate the results of operative treatment of femur shaft fractures in the age group between 6 and 16 years with titanium elastic nailing system (TENS), using Flynn’s criteria.

METHODS: This prospective clinical study was conducted during the period from November 2018 to November 2020. Thirty cases were treated with mean follow up of 12 months.

RESULTS: The final outcome was excellent in 21 cases, satisfactory in 6 cases and there were 3 poor outcome cases. Eight patients had limb length discrepancy varying from 0.5-2cm. Five patients had skin irritation, 3 patients had angular mal-union and 1 patient had persistent pain with skin breakdown. None of the patient had infection, rotational mal-union, delayed or non union.

CONCLUSION: Titanium elastic nail fixation is a simple, easy and effective method for management of paediatric femur fracture between 6 and 16 years age. With this method of treatment, careful consideration to patient’s age and body weight should be given to prevent the poor result.