ObjectiveTo compare the effectiveness of locking compression plate and elastic intramedullary nail for the treatment of benign long bone pathological fractures in children, so as to provide the evidence for clinical treatment. MethodsSeventy-two children with long bone pathological fractures who accorded with the inclusion criteria between January 2005 and July 2013 were randomly divided into 2 groups. Fracture was fixed with elastic intramedullary nail in 33 cases (group A) and with locking compression plate in 39 cases (group B). There was no significant difference in sex, age, body mass index, primary lesion, location of fracture, side of fracture, and interval between injury and operation between 2 groups (P>0.05). ResultsGroup A had shorter operation time, less intraoperative blood loss, and less overall costs than group B, showing significant differences (P<0.05). Primary healing of incision was obtained. All the patients were followed up 1-7 years (mean, 3.4 years). Tumor lesions disappeared and the pathological fracture healed after operation by X-ray film observation, and group A had faster fracture healing time than group B (P<0.05). There was no loosening and displacement of internal fixation, bone resorption, and bone defect nonunion in 2 groups. Recurrence was found in 2 cases (6.1%) of group A and 3 cases (7.7%) of group B, showing no significant difference (χ2=0.074, P=0.580). Re-fracture was found in 1 patient with tibial bone cyst of group B after 3 months of operation, and healed after 1 year of open reduction and internal fixation. According to X-ray film and comprehensive function evaluation of shoulder, elbow, hip, knee, and ankle, the results were all excellent in 2 groups at last follow-up. ConclusionElastic intramedullary nail fixation should be the first choice, and locking compression plate should be the second choice for children with benign long bone pathological fractures.