Pediatricians often say that a child is more than just a little adult. In other words, it is to emphasize the differences between children and adults. Children have their own special physiology, which is especially evident in pediatric orthopedics. Because children are in the growth and development period, they are very different from adults in terms of tissue anatomy, physiology, and biomechanics. Therefore, pediatric orthopedics is not a reduced version of adult orthopedics. Fractures in children are the more common injuries. Compared to adults, children’s fractures heal quickly, and even if there is some degree of deformity, it can be improved by adjusting the force line through growth contouring. Children have thicker periosteum, rich blood flow, abundant and active osteoblasts and osteoclasts, and rapid fracture healing, which is also the material basis for their strong plasticity. Non-healing fractures in children are rare, and the younger they are, the closer they are to the epiphysis, the stronger their growth and correction ability. Therefore, children’s fractures can be treated with simple repositioned external fixation in a cast or splint, or internal fixation through pins. The core difference between children’s fractures and adults is also the fact that children’s bones have epiphyseal and growth plate structures. The epiphysis and growth plate are generally located at the ends of the long bones and are responsible for the growth of the child’s bones. Injuries to the epiphysis that form bridges can cause growth arrest or lead to inward and outward deformity of the joint in which they are located. Therefore, epiphyseal injuries should be repositioned anatomically and fixed internally and externally as much as possible. Once the epiphysis closes prematurely, it is very easy to develop skeletal growth arrest or inversion deformity. The deformity should be treated by bone lengthening or osteotomy after the growth has stopped. The epiphyseal opening technique has been gradually carried out in large hospitals in China, and the treatment effect is good and has yet to be popularized. In addition to traumatic fractures, pediatric orthopedics mainly includes various congenital or acquired deformities, developmental disorders, infections and tumors. For example, developmental hip dislocation, congenital clubfoot, Perthes disease, Blount’s disease, hematogenous osteomyelitis, septic arthritis and various benign and malignant tumors of the skeletal muscular system. Therefore, pediatric orthopedics is not a reduced version of adult orthopedics. In addition to adult fractures and skeletal diseases, pediatric orthopedics also has many congenital and developmental diseases that are not found in adults, and includes a larger and broader spectrum of diseases than adult orthopedics. Many pediatric orthopedic diseases are treated in the same way as adults, and cases with serious consequences occur repeatedly. Therefore, all pediatric orthopedic diseases need to be treated by a specialized pediatric orthopedic surgeon. However, the degree of specialization and the number of specialists in pediatric orthopedics in primary care hospitals in China are seriously inadequate, and there is an urgent need for hospital policy support and training of professionals.