When a child accidentally breaks a bone, what is the best way to treat it is the main concern of parents. Many parents come in a hurry, thinking that they can be conservative without surgery, that surgery requires anesthesia to affect the brain, and even that a cast is a panacea. In fact, how to cure children’s fractures is really not something that can be explained in one or two sentences. Why? Read on. Children’s fractures are “strange” It is difficult to generalize about the treatment of children’s fractures. There are many types of fractures, and compared to adults, children have a better ability to heal and shape after a fracture, which is inversely proportional to their age, and children have special bones so there are special types of fractures, such as epiphyseal injuries, bending fractures, green branch fractures, etc. The epiphysis is a tube for growth and development, and once it is damaged, it will affect growth and development and become deformed. In addition, children’s bones have a higher organic content and are more flexible, so special types of fractures such as bruise fractures can occur. Just like a tree branch, adult bones are like dead wood and break when broken, while children’s bones are like young branches and do not break completely when broken. Children are also prone to bent fractures, where the bone is bent but no visible fracture is visible. Different types of fractures are treated differently It is because of the many types of fractures in children that the treatment is very different from that of adults. The way children’s fractures are treated has a lot to do with the nature of the fracture, the location, the number of fractures, the age of the child and even the season. Whether it is simple fixation, traction, cast, brace fixation or surgery also depends on the situation, and the principle of individualization of treatment for children’s fractures is very strong. For example, if the fracture has a wound that is prone to infection, surgical debridement should be performed. If there is only a fracture without a wound and it is a relatively small child, because of the stronger healing ability, it may be possible to do traction or cast fixation or brace fixation, which is much less likely than surgery for older children; older children are more likely to choose surgery in order not to interfere with normal learning and to be able to return to school soon. In addition, if there are multiple injuries, such as a fall or car accident causing multiple fractures throughout the body, care is more difficult and treatment should be relatively complex. If you want to operate, do minimally invasive treatment as much as possible Even if it is surgery, it is also divided into incision and minimally invasive surgery, children fracture as much as possible to do minimally invasive surgery, no incision will not increase tissue damage, can return to school as soon as possible, and less suffering and good care. Minimally invasive means less trauma, internal or external fixation of the fracture can be done, and external fixation is used more often. Internal fixation requires incision and implantation of a fixation into the body, which is more invasive than external fixation. Children are more resilient, so surgery is not necessary to achieve anatomically perfect repositioning. As shown in the figure, minimally invasive external fixation surgery nails several nails, from outside the body, to the fracture site, and connects the nails together with a metal frame outside the body, allowing for very stable repositioning and fixation. This does not interfere with normal activities and does not require cast fixation, is easier to care for, and can be removed quickly. Some fractures only need to be put in a cast after the fracture has been repositioned manually. There are two main reasons for this, one is that after the fracture, the bone is misaligned and the fracture has to be reset before the cast is applied. The reset needs to be done under the fluoroscope in the operating room, otherwise it is difficult to judge whether the reset is successful. Secondly, there will be some pain in the reset, and the child is nervous and crying without cooperation, which not only cannot be reset, but also may aggravate the fracture displacement and even cause neurovascular damage; after the surgery under general anesthesia, the muscles are relaxed without strength, and the effect of reset will be better. In addition, resetting under general anesthesia also avoids leaving a tense and painful memory for the child, causing a psychological burden. In general, the treatment of children’s fractures is highly individualized and it is best for the doctor and parents to fully communicate and find the most appropriate plan according to the child’s condition. It is best not to think that less pain is the best, and it is not best to open the bones to make them fit tightly. It is important to follow the doctor’s professional advice and make the right choice based on the child’s age and condition.