Children are not the epitome of adults, nor are they small adults. Children’s fracture is a more common injury, due to children in the growth and development period, in the organization of anatomy, physiology, biomechanics and other aspects are very different from adults. First, the children’s bones of the organizational and anatomical characteristics of the skeleton in the human body, the main pillar, regulating mineral metabolism, in children with a unique growth function, or one of the hematopoietic organs. Adult cortical bone is plate layer arrangement, dense and hard. Children are not, especially newborns by the intricate intertwining of the original tissue, no obvious plate structure, have good toughness. With age, the primitive connective tissue is gradually replaced by a laminated structure. In children, the periosteum is thicker and rich in blood flow. The ends of the long bones of the limbs are composed of cartilage called epiphyses, while the metacarpal (metatarsal) bones of the hands and feet and the bones of the fingers (toes) have epiphyses only at one end. Between the epiphysis and the metaphysis, an actively growing cartilaginous area called the epiphyseal plate is formed, showing the typical process of endochondral ossification. According to the histological characteristics the epiphyseal plate is divided into four layers: the quiescent cell layer, the proliferating cell layer, the mast cell layer, and the temporary calcified layer, where the interstitial spaces of the cells are filled with cartilage matrix and cellular matrix, which strengthens the strength of the epiphyseal plate. The mast cell layer, however, is significantly reduced and is prone to epiphyseal separation from here. The blood supply to the epiphyseal plate is distributed by the epiphyseal arteries to the quiescent cell layer on the epiphyseal side, whereas on the metaphyseal side the epiphyseal arteries form capillary collaterals to nourish the temporary calcified layer. The mature epiphyseal plate forms a blood barrier between the epiphysis and the metaphysis. Children’s bones are composed of organic matter forming a matrix, deposited inorganic salts, more water, and less solid components. As a result, children’s bones are more pliable than those of adults and are better able to withstand deforming external forces. Fine pores in the cortex of children’s bone can limit the extension of the fracture line. Adult compression of bone can not tolerate tension, on the contrary, children’s bone is not easy to be compressed by the rich pore. Second, the physiological characteristics of children’s bones children’s bone physiological function in addition to hematopoietic, inorganic salt metabolism and immune function, but also has the ability to grow. In the epiphysis of the cartilage endochondral ossification makes its longitudinal growth, while the periosteum inner layer of cell proliferation ossification that is, periosteum endochondral ossification, so that it grows horizontally. Due to the abundance of osteoblasts and osteoclasts and the high blood flow, its growth and molding ability are stronger than that of adults, and once fractured, the healing speed is also very fast. Epiphyseal ossification occurs at different times in different parts of the body and can be an important indicator of the growth and development of children’s bones. However, once the epiphyseal plate is damaged, it will cause delayed bone growth or osteoarthritic deformity. In addition to the main symptoms of fracture, because of children’s loose soft tissues and elastic fascia, the swelling after fracture is early, extensive and often with ecchymosis. Among the systemic symptoms, the increase in body temperature after fracture is more obvious than that of adults, which can reach more than 38 degrees Celsius, especially in infants, and often lasts for 3 to 5 days, which is due to the absorption of hematoma, and the denatured proteins enter into the blood circulation. X-ray examination after fracture is an indispensable diagnostic method, which can not only determine the diagnosis, but also clarify the type of fracture, displacement, and the presence of primary lesions such as bone cysts, osteogenesis imperfecta, etc., and is also an objective sign of fracture healing. The epiphyses at both ends of the long bones of children are more and more cartilaginous the younger they are, so it is important not to misdiagnose the epiphyseal plate as a fracture line and the small epiphyses as fracture fragments. ct and mri examination can improve the diagnosis. The characteristics of children’s fracture repair Children are in the period of growth and development, osteoblasts and osteoclasts are abundant and active, blood circulation is vigorous, fracture healing is rapid, the younger the age, the faster the healing. Fractures of epiphysis and diaphysis, due to congestion and stimulation of epiphyseal plate overgrowth, can cause temporary growth acceleration of the affected limb, such as femoral stem fracture can be overgrowth of 8-20mm, but the epiphyseal plate suffered damage will lead to different degrees of growth and developmental disorders. In children, after the fracture, the alignment is not good, the formation of shortening, angular deformity can be corrected to a certain extent with the growth and development. The younger the age, the greater the ability to correct. However, entropion and ectropion deformities and rotational deformities cannot be corrected on their own.