Severe pain in the elbow, compression pain and swelling in severe cases, there may be widening of the transverse diameter of the lower end of the humerus, overlapping displacement in heavy cases, there may be shortening deformity of the upper arm. The elbow joint is in half-extension position, the forearm is rotated forward, the bony structure of the posterior elbow triangle is disorganized, the fracture block can be touched, and the bone friction sensation is obvious. Sometimes it can be combined with nerve and blood vessel injury, therefore, attention should be paid to the following five kinds of diseases to be identified during the examination. 1.Dislocation of elbow joint In the absence of humeral tuberosity ossification center, it is not easy to distinguish between the two, careful clinical examination can be found when the distal humeral epiphysis is separated, the relationship between the three points after the elbow is normal, while in the dislocation, there are changes. Sometimes the sound of the cartilage touching each other can be felt by the hand during the revision process, which is helpful in the diagnosis of epiphyseal separation. If the center of humeral tuberosity ossification has appeared, it can be identified according to its relationship with the radius, and if the relationship is abnormal, it is dislocation. 2.Humeral epicondylar fracture The real pathological change is separation of the epiphysis of the humeral epicondyle, at this time, the humeral stem and the radial stem of the alignment of the relationship between the humeral stem and the radial stem is normal, and the humeral tuberosity ossification center is displaced to the lateral side. On physical examination, the active epicondyle can be palpated on the lateral side of the elbow. 3.Elbow dislocation combined with medial or epicondylar fracture It is often difficult to diagnose before the emergence of the humeral tuberosity ossification center. When lateral dislocation is combined with epicondylar fracture, the relationship between the three points behind the elbow is changed, and the epicondyle and the radial head can be palpated on the lateral side of the elbow in normal relationship. When medial dislocation is combined with medial condylar fracture, it is similar to the above situation, i.e. the relationship between the humerus and the medial condyle is normal. 4.Intercondylar fracture of the humerus Mostly seen in adults, rarely in children. In young children, the epiphysis of the slide has not yet ossified, and the fracture line between the condyles cannot be seen directly from the X-ray film, which makes the diagnosis more difficult. Its X-ray characteristics are similar to epicondylar fractures. If compared with the healthy side, the humeral stem and proximal ulnar radius can often be found close to each other. For difficult cases, arthrography can be used to clarify the diagnosis. Fortunately, this kind of injury is very rare in children, and there are not many opportunities for clinical identification. 5, supracondylar humerus fracture usually rely on X-ray and epiphyseal separation is not difficult to identify, only when the epiphyseal bone piece range size is not clear, the two will be confused. In this case, it should be combined with the X-ray film after reset, and then make a diagnosis. This type of misdiagnosis has no impact on treatment, but is statistically significant.