Diaphyseal fractures can be treated in many ways where plating , nailing, external fixation and casting all have their indications and limitations. We have studied the use of Titanium Elastic Nailing used in humeral, femoral and tibial shaft fractures in paediatric and adult groups. Studying the average blood loss, complain of pain, encountered irritation at nail insertion site, fewer scars, easy implant removal, shorter bed stay, angulation, average union time and stability with already establish modalities we found that TENS is an attractive alternative. The elasticity and 6point fixation advantage over enders nails enable it to preserve the length and shape of the bone. This method is therefore well tolerated by doctors and patients.