This chapter, supported by numerous X-ray images, shows osteosynthesis procedures as they appear in imaging. After the general principles of osteosynthesis, the fracture care using wires (Kirschner wire) and screws (traction/adjusting screws, angle-stable and special screws) and plate osteosynthesis (neutralization, compression, support and angle plates) is presented in radiological representation. Intramedullary nail osteosynthesis is used for the treatment of fractures of long tubular bones by driving a metal pin into the marrow space. Furthermore, the different types of external fixator use are described. Bone cement can be used in some body regions as an additional augmentative method or for filling bone defect areas. Cerclages/tension band osteosyntheses and sports orthopedic procedures (including staples, interference screw, suture anchor) round off the chapter.