Objective <p>To study the effect of comfort nursing management of postoperative pediatric upper extremity fractures on the basis of the standard operating procedure (SOP) management model.</p> Methods <p>The clinical data of 150 pediatric upper extremity fracture patients treated postoperatively at our hospital (August 2023–August 2024) were retrospectively analyzed. Participants were divided into a control group (conventional care) and an intervention group (SOP-based comfort care) according to nursing management methods. Postoperative functional exercise outcomes were compared.</p> Results <p>A total of 150 children were enrolled (75 per group). Baseline assessments confirmed no significant differences in joint mobility, joint function, pain, comfort, or psychological resilience scores between groups (all <i>P</i> &gt; 0.05). Post-intervention analyses demonstrated significantly greater joint mobility in the intervention group (<i>P</i> &lt; 0.001), higher joint function scores (<i>P</i> &lt; 0.001), lower pain scores (<i>P</i> &lt; 0.001), improved comfort scores across all dimensions (<i>P</i> &lt; 0.001), and enhanced psychological resilience (<i>P</i> &lt; 0.001), with significantly better functional exercise adherence observed clinically in the intervention group.</p> Conclusion <p>The implementation of SOP-based management model comfort care for pediatric children with upper extremity fractures can improve their postoperative functional exercise cooperation, pain status relief after surgical treatment, emotional stability, and degree of cooperation in the clinical implementation of functional exercise.</p>