Children are very active by nature and are prone to fractures because of their poor awareness and ability to protect themselves. The bone tissue structure and fracture healing characteristics of pediatric patients are very different from those of adults, and they also have their own characteristics in the treatment of fractures. Structural characteristics of pediatric bones 1. The growth plate located at the ends of pediatric bones is a special structure to maintain the growth of bones, and the cells in the cartilage of the epiphyseal plate are constantly differentiating and proliferating to make the bones grow in length. After puberty, the epiphyseal plate gradually loses its proliferative capacity and the bones stop growing. If the epiphyseal plate is damaged by trauma in children, the growth and development of bones will be affected. Compared with adults, pediatric bones have more organic matter and less inorganic matter, so the toughness of the bone is high and the brittleness is low, and the fracture caused by the injury is often like the breaking of a young branch, showing a bending of the bone or only a partial fracture, which is clinically called “green branch fracture”. Of course, if the external force is very high, the bone will be completely broken and obviously misaligned. Pediatric fracture healing is different from that of adults and has the following characteristics: the fracture heals quickly: after the fracture, the periosteum cells on the bone surface differentiate and proliferate to produce new bone, which connects the two ends of the fracture until it heals. Pediatric periosteum has a strong osteogenic capacity, and new bone is produced quickly and abundantly, resulting in a significantly shorter healing time than adults. Pediatric fractures rarely fail to heal. High orthopedic capacity: Pediatric bones have a more advanced ability to correct deformities caused by fractures during growth and development, and even if the fracture has some misalignment (sometimes even more pronounced misalignment), it can be corrected months to years later without leaving any sequelae, as long as the fracture force line is satisfactory and the rotation and shortening displacement are corrected. The principles and methods of management of pediatric fractures are very different from those of adults due to the above-mentioned skeletal structure and fracture healing characteristics. If the physician or the child’s family does not understand these characteristics, the pursuit of anatomical alignment of the fracture will cause unnecessary trauma and greater pain to the child. For the treatment of pediatric fractures, Western medicine is more likely to use incision and internal fixation, which has the advantage of stronger fixation and the disadvantage of greater surgical trauma. The TCM treatment for pediatric fractures is more often by closed reduction splinting (or plaster) external fixation, and the TCM orthopedics has a whole set of fracture reduction methods. We have accumulated rich experience in treating fractures of the extremities (including pediatric fractures). For fractures of the clavicle, humeral stem, supracondylar humerus, ulnar radius, distal radius, as well as fractures of the femur and tibiofibula of the lower extremities, which are prone to occur in pediatric patients, closed reduction can be achieved with satisfactory results, and external fixation with splints or casts. On the basis of closed reduction, the fracture is treated with a minimally invasive fixation method (e.g., percutaneous needle fixation). This treatment method has several advantages: one is that the surgical incision and trauma are much smaller than the conventional methods in Western medicine, which is often referred to as minimally invasive; on the other hand, the fixation of the fracture is stronger and does not require prolonged plaster (or splint) fixation and prolonged braking of the injured limb, which allows the child to move early and is in line with the child’s active nature.