With the development of our society and the improvement of people’s living standards, children’s mobility and range of activities are increasing. As a result, fracture trauma in children is also increasing, including many compound injuries and multiple fractures caused by traffic accidents. For a long time, due to habitual thinking, people tend to think that children are just a microcosm of adults, just smaller in stature and lighter in weight. However, people have overlooked an important issue, that is, children are constantly growing and developing, and their anatomical structure, physiological functions and biomechanical properties are constantly changing, which are not the same as those of adult bones. During children’s growth and development, it is possible for some fracture deformities to heal and correct themselves, as well as for fractures without deformity to heal with deformity and limb length inequality. Due to the unbalanced development of pediatric orthopedics, many pediatric fracture traumas were previously treated by adult orthopedic surgeons concurrently, often applying adult orthopedic perspectives to the treatment. So much so that some epiphyseal injuries (not shown on X-rays) are often missed in diagnosis, while some normal variants of X-rays are misdiagnosed and treated as fractures. Many patients with fractures that do not require surgery are also treated with surgery, and some of these children subsequently develop deformities due to damage to the growth structures (epiphyseal plates) during surgery. With the increasing understanding of the healing mechanisms of pediatric fractures and the development of orthopedic devices, orthopedic internal fixation devices specifically designed for children are available, and treatment methods have been greatly improved. Some fractures that would otherwise require a “big cut” now require very little surgery to achieve the same or even better results. Pediatric fracture trauma has its own characteristics, most of the fracture can be treated by closed reduction, and in some cases, even if the fracture reduction is “ineffective” and there is “misalignment” left, children can rely on their strong molding ability to correct a certain extent of the fracture on their own during the process of growth and development. In some cases, even if the fracture is not “corrected” well and a “malposition” remains, the child can use his or her strong molding ability to correct the deformity on his or her own to a certain extent during growth. On the contrary, some physicians know that pediatric fractures heal quickly and have strong molding ability, but neglect some fractures that require timely surgical treatment, such as epiphyseal fractures and intra-articular fractures, which, if diagnosis and treatment are delayed, can cause deformity and disability. In conclusion, we emphasize that “the pediatric patient is not a microcosm of the adult” and that “it is the patient who should be treated, not the radiographs”.