Objective To compare the clinical effects of intramedullary nails and locking compression plate in the treatment of femur shaft fracture.Methods The clinical data and follow-up records of 43 patients with femur shaft fracture treated by intramedullary nails and locking compression plate were retrospectively reviewed.Including 31 males and 12 females with an average age of 40.07 years(25 to73).According to AO classification:5 cases were type A,24 cases were type B,14 cases were type C.26 patients in group A treated by intramedullary nails and 17 patients in group B treated by locking compression plate.Operation time,fracture union time,blood loss and complications were compared between the two groups.The Karlstrom and Olerud result were compared and analyzed.Results All patients were followed up at an average of 15 months(range 5-24) after surgery.According to Karlstrom and Olerud score system,the excellent and good rate of group A was 88.4％,higher than the group B 82.3％.But there was no significant difference between the two groups.In group A:the operation time (113.77 ±20.14)min,the blood loss in the operation (386.74 ± 65.16) ml,clinical bone healing (15.52 ± 1.77) weeks.All these outcomes were better than group B (P ＜ 0.01).One case in group A appeared screw loose,but X-ray showed the nail stable,the bone wasn't displacement.One case in group B appeared broken plate 1 month after operation,and received twice operation,the clinical outcome was good as well.Another 1 case with fracture delayed union in group B,after internal fixation removed,we check the X-ray showed bone union.Conclusion Two methods of treatment femur shaft fracture can all reach the above requirement.Fixation of intramedullary interlocking nail is the preferred surgery than locking compression plate.