Most of the fractures in children can be treated by repositioning; however, some of the more complex fractures need to be treated surgically. The common ones are as follows: 1. fractures that cannot be repositioned or maintained and cause deformed healing, which cannot be corrected by themselves through growth and development and directly affect their functional activities and appearance in the future; 2. displaced epiphyseal fractures and intra-articular fractures that require strict repositioning, and if they cannot be achieved, surgical anatomical repositioning is necessary; 3. multiple fractures or combined with other organ injuries to resolve the treatment and care 4. combined with vascular nerve injury, surgery is mainly to explore the vascular nerve. With the continuous understanding of the healing mechanism after pediatric fracture and the continuous development of orthopedic instruments, the treatment methods have been greatly improved. With C-arm X-ray machines, new orthopedic internal fixation instruments (titanium elastic intramedullary nails, hollow screws, titanium nail plates, absorbable screws, etc.), some fractures that would have required a “major incision” now require only a small surgical incision to achieve the same or better results.