88 paediatric patients with a femoral fracture were randomized to undergo fixation using titanium elastic nails by either a paediatric orthopaedist or by a non-paediatric orthopaedist. Perioperative outcomes included operative time, fluoroscopy time, the length of stay, and the number of cases requiring open reduction. Patients were assessed postoperatively for time to union, outcome on the TEN outcome scoring system, and for the incidence of complications. Results demonstrated a significantly shorter operative time, shorter fluoroscopy time, and lower number of cases requiring open reduction in the pediatric orthopedist group. No significant differences were observed in time to union, final surgical outcome, or in the incidence of complications.