Minimally invasive technology is an emerging international surgical technique in recent years, which refers to the purpose of curing diseases with minimal trauma, and it is the goal that surgeons around the world are striving for. Minimally invasive technology is not only an example of modern science and technology applied in medicine, but also a milestone in the history of surgical development. And the application of minimally invasive technology in orthopedics will surely bring gospel to the rehabilitation of the majority of fracture patients. With the development of transportation, fractures caused by high-energy injuries are also increasing. According to statistics, it causes more human, material and financial losses than any kind of disaster, trauma or disease, and has become the biggest public health problem in the modern global society. As the cradle of limb replantation in China and the birthplace of “Chinese hand”, the Department of Orthopedics of Shanghai Sixth People’s Hospital has made great contributions to keep the level of microsurgery technology in China in the leading position internationally. In the last decade or so, our orthopaedic colleagues in clinical work have focused on the application of minimally invasive techniques in orthopaedics, which has been recognized by international surgery as the direction and focus of surgical development. We know that in the past, anatomical repositioning and strong internal fixation were pursued for any fracture, and the soft tissues attached to the fracture fragments were extensively stripped in order to seek the advantages of extensive exposure and direct visual repositioning of the fracture. In the treatment of fractures, the extensive stripping of soft tissues attached to the fracture fragments is precisely one of the major causes of deep infection, non-union of bone, and the need for stage I or II bone grafting. At present, the principle of minimally invasive biological technique of internal fixation has been commonly used in our orthopedic department to treat various kinds of fractures, and nearly 3,000 cases of limb fracture fixation surgery are completed every year, which has achieved good clinical treatment results and gained the trust and praise of fracture patients. The following is only a brief introduction to several common minimally invasive techniques for fracture treatment. Closed reduction percutaneous internal fixation for femoral neck fracture Fracture of the femoral neck is one of the common fractures in the elderly. The average age of occurrence is high, osteoporosis is the main cause, and most patients have coexisting medical diseases. Early surgical treatment has been widely accepted to allow early functional exercise, reduce complications due to prolonged bed rest, and significantly reduce mortality. In the past, treatment required a large incision for exposure and internal fixation, often with significant patient trauma, the need for blood transfusion, and many postoperative complications. At present, we use a surgical traction bed to reposition the fracture, and after the fluoroscopy under the C-arm X-ray machine, three guide pins are inserted percutaneously under the C-arm X-ray machine, and then three hollow nails are driven along the guide pins for the fixation of the femoral neck fracture, which only requires three small incisions of less than 1 cm on the skin and three stitches after surgery. The patient can be discharged home in about three days. The traditional fracture plate fixation technique will aggravate the destruction of blood supply to the fracture block and endanger its survival, which will eventually affect the healing of the fracture. How to minimize the trauma to the bone and surrounding soft tissues during surgery and to obtain a stable and biologically appropriate environment for fracture healing is a current research direction in orthopedic treatment. The percutaneous minimally invasive plate internal fixation technique is a technique that does not expose the comminuted fracture site, indirectly repositioned through intraoperative use of external fixation brace technique, and fixed after the plate is bridged over the fracture site percutaneously, which interferes little with the blood flow to the fracture site, especially the bone fragments, reduces the medical source damage and meets the biological requirements of tissue repair. Compared with the traditional open internal fixation technique, the percutaneous minimally invasive plate internal fixation technique has the following features: (1) no exposure of the comminuted fracture site, thus minimizing the damage to the blood supply of the fracture fragments; (2) small incisions at both ends reveal only the two main fracture blocks proximal and distal to the fracture, and the plate traverses the comminuted fracture site through a tunnel between the muscle and the femoral periosteum; (3) non-invasive instruments and techniques are used during the procedure. (4) Indirect repositioning with the help of external fixation brace and plate under C-arm X-ray fluoroscopic surveillance, which only requires correction of the axis, rotation and length of the fracture. III. Closed reduction intramedullary nailing technique Closed nailing technique is one of the greatest advances made in the treatment of fractures in this century. Patients can be internally fixed by closed reduction on a traction bed, fluoroscopy under C-arm X-ray machine, and penetration of intramedullary nail after the fracture is clearly well set, with minimal surgical incision and trauma. In recent years, due to the increasing precision of the locking nail guiding instruments, the patient and the operator can avoid the exposure to X-rays. the C-arm laser guiding device will replace the X-rays instruments, and the closed nail-piercing technique will become more perfect and safe. The outstanding advantage of intramedullary nailing with locking is that it expands the surgical indications of the original intramedullary nail, which is only applicable to the upper middle 1/3 transverse or short oblique canal fracture, while the intramedullary nail with locking is expanded to any type of fracture in the middle and lower segments. This has improved the fracture healing rate and reduced the infection rate. In recent years, locking humeral intramedullary nails have been introduced. The solid tibial intramedullary nail, which does not require marrow expansion and has a smaller diameter, has been used urgently in open calf fractures with satisfactory results. The design of the locking nail pointing in the direction of the femoral head allows the intramedullary fixation of comminuted fractures of the upper middle femoral stem, combined with femoral neck or inter-rotor fractures to be completed in a single operation, and the improvement and promotion of X-ray image enhancement equipment and the update of surgical instruments and orthopedic tables have further emphasized the advantages of this treatment method, thus enabling early functional exercise, reducing complications caused by prolonged bed rest, and significantly reducing mortality. LISS minimally invasive fixation system is another excellent application of minimally invasive technology in the field of orthopedic trauma, which applies the advantages of external fixation stent to internal fixation, and discards the disadvantages of external fixation stent which is unstable, easy to loosen and easy to be infected. The plate does not need to contact with the periosteum, which can minimize trauma to the bone and surrounding soft tissues during surgery and obtain a stable and biological environment suitable for fracture healing, which has the advantages of less trauma, fewer surgical complications and early healing compared with the traditional open reduction mounting method. Although minimally invasive orthopedic surgery technology has been applied in China for just over ten years, it has achieved promising results, gained important progress, and has reached the world advanced level. The Department of Orthopedics of Shanghai Sixth People’s Hospital, as the clinical medical center of traumatology and orthopedics in Shanghai, has taken the lead in the research and application of new minimally invasive surgical techniques in China, and has applied minimally invasive techniques to treat more than 10,000 cases of various fractures, which is a leading position in China.