In childhood, most fractures around the proximal radius are radial neck fractures, according to the AO Pediatric classification (Slongo and Audigé, Acta Orthop 32:S117–S140, 2018; Joeris et al., Acta Orthop 88(2):129–132, 2017) classified as types 21r-M and 21r-E. Real radial head fractures are rare and are not the primary focus of this chapter. There is still a debate about the degree of angulation at which repositioning is necessary. We believe that this debate should no longer arise today, as we know that the proximal radius has a very low correction potential. On the other hand, we now have very simple, minimally invasive procedures at our disposal that, when used correctly, lead to excellent results. Therefore, over all the last years, the absolute gold standard for the treatment of all these fractures is the closed indirect reduction and internal fixation according to the elastic stable intramedullary nailing (ESIN) technique (González-Herranz et al., J Pediatr Orthop 17(3):325–331, 1997; Dietz et al., AO manual of fracture management. Elastic stable intramedullary nailing (ESIN) in children. Thieme, Stuttgart, 2006). Open reduction and internal fixation should be avoided as we see more problems such as AVN, unstable fixation, joint stiffness, and radioulnar synostosis with bad functional outcomes (Falciglia et al., J Pediatr Orthop 34(8):756–762, 2014). On the other hand, the ESIN method leads to a more frequent indication for an operative treatment, as the advantages of this technique are high. The functional postoperative treatment is one of the most important.