A total of 49 children with acute traumatic diaphyseal fractures of the femur were randomized to receive fixation with a titanium elastic nail or intramedullary Kirshner wire (K-wire). The primary outcomes of interest was fracture union (as measured by the modified radiographic union for tibial fractures [mRUST] score), and the incidence of complications leading to unplanned surgery. Secondary outcomes of interest included Pediatric Quality of Life Inventory (PedsQL) scores and recovery milestones ( i.e., time to walking with aids, time to independent walking, time until full activity allowed). Outcomes were assessed at 2- weeks, 6-weeks, 3-months, 6-months, and 12-months post-operation. No statistically significant differences in PedsQL were reported between groups at all time-points; however, improvements from baseline were observed. Similar rates of fracture union were observed in both groups.