Abstract： Objective:To explore the therapeutic efficacies of fracture reductor reduction versus manual traction reduction for femoral fracture with elastic nail in children.Methods:For this retrospective case-control study, a total of 49 children of femoral fractures undergoing titanium elastic intramedullary nailing from October 2016 to April 2019. Based upon different treatments, they were assigned into fracture restorer group (external fixation redactor, n=25) and manual traction group (manual traction, n=24). The success rate of closed reduction, operative duration, fluoroscopic time and intraoperative blood loss were compared between two groups. Postoperative follow-up evaluations for limb function were performed according to the criteria of Flynn.Results:In fracture restorer group, 24/25 children achieved closed reduction and 13/24 in manual traction group. Significant inter-group difference existed in success rate of closed reduction ( P<0.05). Operative duration (41.8±6.5) min, fluoroscopic time (21.1±5.8) s and blood loss (12.2±7.2) ml were less in fracture restorer group than those in manual traction group [(49.7±8.4) min, (26.3±6.4) s & (23.0±13.9) ml] and the differences were statistically significant ( P<0.05). At the last follow-up, femoral fracture score of fracture restorer group was excellent (n=23) and decent (n=2) while the excellent and decent rate was 100% for both groups. Conclusions:For pediatric femoral fractures with elastic intramedullary nailing, fracture restorer may achieve a higher rate of closed reduction than manual traction reduction. It also offers the advantages of shorter operative duration, less fluoroscopic time and smaller intraoperative blood loss.