The Adolescent diaphyseal fractures (Femur, Tibia & Fibula, Humerus, Radius & Ulna) pose a dilemma regarding the optimal treatment. During this period the skeleton is actively growing, so any form of treatment should be such that at one hand it should not restrict the mobility / easy nursing of the child as occurs in different conservative mode of treatments and on the other hand it should not damage the growing ends of the bone as may occur in some operative procedures like rigid nailing. So, keeping these problems in mind a most suited & balanced approach to manage these fractures in Adolescents is Elastic intramedullary nailing. This is simple, minimally invasive technique with minimal implantation. There is least soft tissue dissection, blood loss & cosmetic damage. There is small learning curve and no risk of pressure sores or growth disturbances. Elastic intramedullary nailing provides a combination of elastic mobility & stability. Living tissues also provide stability and aid in the rapid healing with minimal growth disturbance thus leading to rapid return of function - hence it is a Physiological method of treatment.