Treatment of ankle fractures in 9-year-old children includes non-operative and operative treatment such as manipulation and cast immobilization. After thorough study of the imaging data and determination of the type of fracture, children who are able to be manipulated are firstly manipulated. After adequate anesthesia, the manipulation was performed according to the counter-traumatic mechanism, and the fracture was aligned from the distal to the proximal fracture. The fracture is immobilized in a cast for 6 to 8 weeks, after which the cast is removed and the fracture is gradually weight-bearing. For patients who have difficulty in manipulating the fracture, or who cannot successfully maintain the reduction, internal fixation with incisional reduction is required. Internal fixation with tension screws is usually used to keep it stable. If the tibiofibula of the lower limb requires joint fixation, it can be fixed with bone nails and then immobilized in a plaster cast for 6 to 8 weeks after surgery. Ankle fractures in 9-year-old children are recommended to seek timely medical treatment to avoid delays.