In recent times, our pediatric surgery department has admitted some children with distal humerus fractures, most of them were given external fixation in plaster, but at the same time nearly 10 children underwent surgical treatment. Why is there such a concentration of children with distal humerus fractures? Most humeral fractures in children are supracondylar fractures and fractures involving the unicondyle. We found some epidemiological statistics that are very interesting to look at together. Distal humeral fractures account for 23.2% of all humeral fractures in adults, however, they are as high as 85.4% in children. The high incidence of humeral fractures is from 0 to 10 years of age, with the most proximal fractures in adults and the most distal fractures in children. Fractures of the distal humerus in children are closely related to the anatomical structure of the humerus. During the growth and development of children, the distal humerus mainly grows and thickening lags behind growth, and the medial and lateral condyles of the distal humerus (the main mechanical structures) are significantly weaker than other parts of the humerus in terms of both bone quality and bone quantity, making them highly susceptible to fracture. Humeral fractures in children have certain common features: the fracture fragments are composed mainly of cartilage; in immature children, the fracture fragments are smaller than they actually are in the radiographs, and these may cause the radiographs to show no fracture or only a slight fracture, when in fact the estimation may be grossly underestimated, even when the fracture is very significantly displaced. We recently encountered a 9-year-old child who was diagnosed with an internal humeral condyle fracture (mildly displaced) at a local county hospital and given simple external fixation in a cast, when in fact the actual degree of displacement was much greater (Figure 1) and the child at one point presented with clinical signs of ulnar nerve entrapment. The diagnosis was not corrected after visiting several hospitals to take pictures. It was not until 20 days after the fracture that the child came to our Children’s Hospital for surgery and was given an incision and internal fixation, during which it was seen that the fracture was significantly displaced and the ulnar nerve was partially damaged by the fracture fragment. The risk of insidious distal humerus fracture in children is evident. How can fractures of the distal humerus in children be prevented? Due to the inherent structural fragility of the distal humerus in children, this characteristic is unlikely to change radically at this age, and unfortunately, distal humerus fractures in children are difficult to prevent, which is the fundamental reason why the incidence of these fractures is difficult to decrease. However, we can still find some prevention methods, such as: ① do not play in high places, or only when you have a guardian; ② try to use non-slip flooring or wooden flooring indoors; ③ wear protective gear when riding bicycles or roller skating; ④ most importantly, once the trauma occurs, go to the hospital as soon as possible, preferably to a children’s hospital surgery or orthopedic department, and ask an experienced orthopedic surgeon to do a detailed examination, take pictures, and diagnosis, and treatment (as in Figure 2). Finally, we hope that our efforts will expose the hidden risks in distal humeral fractures in children to the sunlight. Figure 1 The arrow shows the fracture block Figure 2 Supracondylar humerus fracture after manipulation and Blount cast external fixation