Elbow trauma in children has the highest incidence of all pediatric osteoarticular injuries. In clinical work, due to the uniqueness of children’s bones, we often encounter patients who do not receive good treatment. It is heartbreaking to see the deformity left behind and the desperate eyes of the child’s parents. Most of the reasons for these situations are due to the lack of awareness or improper treatment of pediatric elbow injuries by non-professional doctors; a small part is due to the lack of awareness of parents about the treatment of injuries and their failure to recognize the consequences of non-correct treatment. Some parents even treat their children themselves at home. For example, in children with Meng fractures, the humeral radial joint is dislocated and deformed because the radial head is not repositioned; patients with humeral epicondylar fractures are left with local pseudoarticular deformities and so on. The most common elbow injury in children is a supracondylar humerus fracture. For fractures that are not heavily displaced, they can be treated by external fixation through manual repositioning. For displaced fractures, repositioning may also be attempted. If the fracture is stable after reduction, then it can be treated by external fixation; for unstable fractures after reduction, supracondylar humerus fractures with combined neurovascular injury and old supracondylar humerus fractures, surgical treatment is required. Fixation is usually performed with a repositioned crossed kyphotic pin. Humeral epicondylar fracture and humeral medial condyle fracture This fracture injures the epiphysis, epiphysis, and humeral articular surface, and generally requires incision and repositioning surgical treatment, except for the first type which is treated by external fixation. Tight anatomical repositioning is generally required during surgery. Keep the joint surface flat. Because articular cartilage is generally not capable of repair, if the articular surface is not kept tightly aligned and flat, traumatic arthritis will occur sooner or later. Of course, due to this type of fracture, the blood flow of the medial and lateral condyles is impaired, which may cause abnormal development of the local epiphysis in the future and cause the residual elbow joint inversion deformity. This is something that cannot be done by current medicine. It can only be treated by osteotomy orthopedic treatment after the deformity appears. If the disease is not well understood and conservative treatment is used, it is easy to develop osteosclerosis at the fracture site, forming pseudoarticular deformity and ulnar neuritis. Ulnar hawk’s-jaw fracture Simple ulnar hawk’s-jaw fracture is not uncommon in clinical practice. Because the proximal part of the ulnar joint has not yet ossified, it remains cartilaginous. X-rays do not show it clearly. If the fracture is fixed by closed reduction. It is advisable to perform an MRI to determine if the articular surface is flat. If it is not flat, it will need to be repositioned or treated by incisional surgery. Fractures of the radial tuberosity are rare clinically. However, it can easily cause necrosis of the radial tuberosity. Therefore, many doctors and parents delay treatment because of the fear of radial head necrosis. For the management of this fracture, if the fracture is not heavily displaced and angulated, or if it can be repositioned by manipulation, it is recommended to treat it with external fixation by manipulation. Otherwise, surgical treatment is required. Surgery is usually performed with fine kerf fixation. Monsignor fracture? A Monsignor’s fracture is a fracture of the proximal 1/3 of the ulna combined with a dislocation of the radial head. This fracture is not uncommon in pediatric elbow trauma. Because of confusion about the diagnosis and treatment of the disease, some are misdiagnosed as ulnar fractures and treated for the fracture alone. The radial head is not repositioned. This eventually results in old radial head dislocation and even leads to deformity. In particular, some patients with Manganese fractures in which the ulnar fracture repositioned on its own after injury are more likely to be misdiagnosed. This type of fracture is best treated by an experienced pediatric surgeon. To avoid lifelong regrets. Elbow dislocation This type of elbow injury is relatively rare in children with elbow trauma and can usually be successfully treated early with manipulative repositioning and external fixation. However, attention must be paid to the combination of coronoid fracture and ulnar hawkbone fracture. A free coronoid fracture fragment can enter the joint and interfere with joint motion, resulting in loss of joint range of motion. Separation of the distal humeral epiphysis Separation of the distal humeral epiphysis in children is an intra-articular fracture. Because this fracture is an epiphyseal fracture, the fracture line is not visible on X-rays and is often misdiagnosed by surgeons and radiologists unfamiliar with this condition. There is a 20-25° angle of intersection between the humeral stem and the distal humerus, and a lateral radiograph of the separated distal humeral epiphysis shows an increased abnormality in this angle. Treatment of this fracture can be attempted with external fixation by manipulation. If fixation is not possible, treatment should be done by incision and fixation. Otherwise, once the deformity heals, it will result in limited elbow extension and hemi-flexion deformity of the elbow joint. Injuries to the elbow that are combined with nerve injury and vascular injury should be treated immediately in an emergency hospital. If necessary, surgical treatment should be performed. To avoid irreversible consequences. For old elbow trauma, it should also be treated actively. Dislocation of the radial head remaining from a Mons fracture requires an early hospital visit for joint repositioning + annular ligament reconstruction surgery. Old fractures of the internal and external humeral condyles should be more aggressively treated surgically. As far as possible, repositioning and fixation surgery should be performed. Residual elbow inversion deformity and abnormal range of elbow flexion and extension should also be treated with orthopedic surgery in order to obtain better elbow function.