There was an increased interest in the operative treatment of paediatric fractures in the past two decades, although debate persisted over its indications. There is a little disagreement concerning the treatment of femur fractures in children less than 5 years (POP cast) and adolescents older than 15 years (locked intramedullary nailing). Controversy persists regarding the age between 5 to 15 years. Several treatment options for femoral shaft fractures in children and adolescents have been described. Children below the age of 3 can be treated with cast or extensional devices. In the past two decades the management of displaced femoral shaft fractures in older children has gradually evolved toward a more operative approach due to a more rapid recovery, faster reintegration of the patients and possible negative effects of immobilization even in children. Orthopaedic surgeons will continue to face the challenge to treat this age group with less morbidity at a lower cost, as no clear guidelines have been available until now despite efforts done initially by French surgeons, later on by European surgeons and recently by the Paediatric Orthopaedic Society of North America (POSNA).
Conclusion: There was no significant association observed between clinical variables (age, gender, mode of injury, pattern of fracture and time interval between trauma and surgery) and incidence of complications.