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We report 144 femoral shaft fractures (FSF) in 138 children <15 years old. The boy/girl ratio was 2.8:1. The incidence rate was 28 per 100,000 child-years. Young children (<3 years) had the highest incidence rates. The most common etiology was trauma due to traffic accidents (43.1%) and falls (42.2%). Falling off bicycles contributed to 4.9%, direct trauma to 3.5%, and jamming to 5.6% of fractures. Involvement of children in traffic accidents and the number of FSFs due to traffic trauma fell significantly during the study period. The resource consumption of FSF was very high compared to other childhood fractures. The mean length of stay for FSF was almost three times that of all other patients seen in the emergency unit.