الفهرس 
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Abstract
Introduction
Treatment of the femoral shaft fracture in children is controversial especially in children of age 6-12 years. Commonly used options include conservative with skin or skeletal traction, hip Spica cast and operative with external fixation, open reduction and internal fixation with plating and close reduction and internal fixation under image intensifier with the flexible titanium elastic nails.
AIM OF THE WORK
This essay aims to study the outcome of elastic nail system in diaphyseal femoral fracture in children, and how this system has become the choice of stabilization in pediatric long bone fractures, particularly the femoral shaft fractures.
SUMMARY AND CONCLUSION
The elastic stable nailing is an effective treatment option in treating femoral shaft fractures in the 6-16 years age group. In the hands of an experienced ESINs user together with the correct technique, not only all transverse femoral fractures are stabilized by intramedullary nailing but also a majority of oblique, spiral and even some comminuted fractures. Pre-bending of nails is generally held to be an essential part of the ESIN technique. Leaving no more than 2 cm at the end of the nail outside the bone and cutting the nails flush to lie against the metaphyseal flare of the femoral condyle is very important to avoid nail entry irritation which is the most common complication of the technique. the use of end caps elastic nails may have role to stabilize fractures and to avoid nail entry irritation. the use of “blind hand” technique as an alternative to closed reduction have role to prevent extensive intraoperative radiation exposure and to decrease the length of the surgical procedure. stainless steel nails produce results similar to titanium nails at considerably less price. This procedure can be done efficaciously and safely even in small hospital settings. It decreases the cost by shortening the hospital stay and post-operative care.