Aims: To evaluate one of the surgical options for treating femoral fractures in children.

Methods: In a consecutive and prospective study during the period 1993–2000, 96 children aged 3–15 years with 98 displaced fractures femoral fractures were treated with external fixation and early mobilization.

Results: All fractures healed. Minor complications included pin tract infections (18%) and clinical insignificant malunions. Major complications (6%) included 2 refractures after significant trauma and three plastic deformations after premature fixator removal. Malunions remodelled almost completely, overgrowth was far less than expected. Isokinetic muscle strength was tested for both hamstrings and quadriceps and showed no residual weakness.

Conclusions: External fixation of displaced femoral fractures can be used as surgical alternative in children aged 3–15 years. The treatment provides satisfactory results with a low rate of major complications. Early mobilization seems to prevent residual muscle weakness. The treatment reduces the number of days in hospital for the child and the number of days of sick leave for the parents.