Very young patients can present to your clinic with diaphyseal humeral or femoral fractures. Unfortunately, they may not have the budget to have the fracture properly repaired, and an amputation is often recommended. However, these immature patients with femoral or humeral diaphyseal fractures can often do well with conservative management.
Conservative management in these cases usually entail crate rest, pain management and repeating radiographs in 10-14 days. I do not advocate splinting, because (1) a femoral fracture should never be splinted, and (2) a spica splint for a humeral fracture is often too bulky for these small, immature patients.
Once there is a bridging callous, the limb function tends to be excellent to adequate, depending on the amount of displacement in the fracture. The heavy musculature around the humerus and femur tend to maintain the joints above and below the fracture reasonably aligned. At this very young age, the fractures heal very quickly which contributes to a rapid return to function and diminished pain. If the healed bone is shorter than the contralateral one, the other bones in the limb and the joints tend to compensate for the disparity – thus the shortened bone becomes clinically unnoticeable.
The best way to manage these fractures is with surgical repair. Should that option not be available, I recommend conservative management over amputation. Of course, in the small percentage of patients in which the conservative management does not result in adequate function and use of the limb, then amputation would be indicated.