Fractures of the radial neck in children are often seen in clinical practice, with radiographs showing a fracture or a “crooked cap” of the epiphysis. For fractures of O′brien type II and III degrees of displacement (>30 degrees), it is difficult to achieve good repositioning by traditional revision methods, and surgical treatment has many complications, difficult internal fixation and easy re-displacement. In recent years, with the continuous improvement of new materials and technologies as well as the development of minimally invasive concept and minimally invasive techniques, more and more children’s fractures are treated by minimally invasive surgery, especially for unstable fractures of the extremities in children, intramedullary fixation techniques have been widely accepted. The elastic stable intramedullary nail (ESIN) was first reported by Frenchman Jean Prevot in the late 1970s. The operator can pre-bend the intramedullary nail according to the characteristics of the fracture to achieve two or more points of fixation with fracture repositioning effect, while the fracture end is kept in longitudinal micro-motion to promote bone scab formation, so the elastic stable intramedullary nail is a minimally invasive procedure suitable for the treatment of children’s fractures. In the treatment of radial neck fractures in children, the flexible intramedullary nail can balance the repositioning and fixation. Radial neck fractures in children are intra-articular fractures of the elbow joint, which require anatomic or subanatomic repositioning as much as possible, otherwise they may affect elbow flexion and extension and forearm rotation. For fractures with mild displacement of the radial neck fracture, the fracture is generally more stable by manipulation, but for fractures with radial head tilt greater than 60° or with elbow joint dislocation, the lateral edge of the radial neck often has different degrees of insertion and compression, and the joint capsule around the joint is torn and destroyed, and the lateral radial head loses the support of the original radial neck after repositioning, which is mostly unstable. At present, the clinical treatment mostly adopts percutaneous prying and repositioning external fixation, percutaneous prying and repositioning internal fixation, incision and repositioning external fixation or incision and repositioning internal fixation, etc. After surgery, the simple external fixation has the possibility of re-displacement, plus the operation of internal fixation with a kerfing needle is difficult, and it is easy to cause postoperative ischemic necrosis of the radial tuberosity. The tip of the intramedullary nail hooks on the distal end of the fracture and plays the role of repositioning by rotation. The curved head of the elastic nail facilitates the insertion of the intramedullary nail and fixes the proximal end of the fracture at the same time to avoid re-displacement, which results in a higher success rate of closed fracture repositioning and more accurate efficacy. The advantages of the elastic intramedullary nail in the treatment of radial neck fracture in children a) It conforms to the minimally invasive technique, only a small incision is needed at the epiphysis, which is less traumatic, easy to operate and has less scar; b) The titanium elastic intramedullary nail can better control the axial displacement, translation and rotation of the fracture, so that the fracture is in a biologically stable state and has sufficient stability for early activities, and at the same time, it avoids joint stiffness, muscle atrophy and other complications caused by prolonged external fixation; c) The elastic intramedullary nail can facilitate the insertion of the nail and at the same time, avoiding redisplacement. c) The flexible intramedullary nail is a flexible intramedullary nail, which can penetrate in the direction of the medullary cavity without using the medullary drill and disrupting the endosteal blood supply, without cutting the periosteum and the hematoma at the fracture, avoiding damage to the blood supply of the fracture block and facilitating the natural healing of the fracture. In this group, the fracture of the radial neck was seen to pass through the bone scab 3 to 4 weeks after surgery, avoiding the poor prognosis of ischemic necrosis and then resorption of the radial head, which is common in the incision and repositioning method and unacceptable to both doctors and patients; d) the infection rate is reduced by not exposing the fracture end by incision; e) the internal fixation is simple to remove after the fracture heals, and can be removed only by incision and subcutaneous extraction, saving time and cost. a) Preoperative films should be carefully read to clarify the direction of fracture displacement and make a good repositioning plan; b) The opening should avoid injuring the epiphyseal plate and affecting the normal development of bone; c) When repositioning the fracture and internal fixation of the intramedullary nail, we should strive for one-time success, and if necessary, prying and repositioning is feasible to avoid repeated retraction, which can lead to hollowing of the proximal end of the fracture and lead to unreliable fixation; d) The angle of the tip of the elastic nail can be properly adjusted intraoperatively, and we generally make the original arc slightly reduced to facilitate intraoperative repositioning and fixation; e) treatment of the nail tail: to stay outside the bone window about 5mm is appropriate, not too long, so as not to occur pseudocysts, and sometimes cause local skin irritation pain and infection.