60 pediatric patients (ages 6 to 11) with femoral shaft fractures were randomized to fracture fixation with either a titanium elastic intramedullary nail or a stainless steel intramedullary nail. Clinical and radiographic data were collected over a 52-week period. Fracture union occurred in all patients between 16 and 22 weeks. There were no significant differences in the duration of surgical procedures, hospital stay, blood loss, incidence of limb length discrepancy greater than 1.5cm, cases of skin irritation/bursitis at the entry point, or other complications between groups. The treatment cost was significantly greater in the titanium elastic nailing group.