Considering our own results with treating 96 children by Küntscher nailing we cannot agree with other authors who prefer conservative treatment of femoral shaft fractures in infancy. Using a special technique which avoids injuries of the epiphyseal zone, we neither found unphysiological differences in legs length nor varus or valgus displacements three months to five years after nail removal. Bacterial infections are extremely rare. Healing mostly follows without complications. In well defined cases we think operative treatment has the following advantages: short period of hospitalization, early mobilization, easy medical care, little x-ray exposition and lowering of costs.