Paediatric femoral fractures are relatively uncommon. Treatment is predicated upon the age of the child, the size of the child, and the type of fracture. Very small children can be treated with an immediate cast called a spica which is put on in the operating theatre with the patient asleep. As patients get older flexible rods can be passed up the hollow part of the bone to hold the bone in position, or paediatric femoral rods can also be used. These are similar to ones used to treat adult fractures but have a smaller diameter. An non-operative alternative for some children is 6 weeks in traction, this depends on the child's age and type of fracture.

Fractures to the shaft of the tibia usually occur from high energy injuries such as sporting contact or motor vehicle accidents. Treatment is operative. Options include having an intra-medullary nail passed down the hollow inside of the bone with locking screws at either end to prevent rotation or shortening. Alternatively plates and screws may be used. Monitoring post-surgery is important to ensure that pressure in the compartment does not increase and threaten the blood supply to the calf muscle. The usual time for a shinbone fracture to heal in an adult is between 18 to 24 weeks, with weight-bearing allowed immediately or at 6 weeks. The risk of non-union of the tibia is higher than for most bones because a significant part of the bone is not surrounded by muscle which normally provides blood supply which helps to heal the fracture.

Femoral shaft fractures refer to fractures below the top of the hip bone and are usually the result of high-energy sporting or motor vehicle accidents. These require fixation with intra-medullary nails or rods which have locking screws at either end to prevent rotation or shortening. The healing rate is very good for these fractures. Femur fractures often occur in association with other injuries as people are often involved in car accidents. It takes between 18 and 24 weeks for the femur to heal but weight-bearing is generally allowed anywhere from immediately up to 6 weeks depending on the degree of common use and or fragmentation of the fracture. Unless there are issues, the medullary nail will be left in place.