The philosophy and techniques for the management of fractures in the pediatric patient have changed over the past several decades. The immature skeleton has unique properties, and injuries in children have different characteristics, management options, and complications than do similar injuries in adults. The basic surgical techniques used in the management of pediatric fractures include closed reduction and casting, closed or open reduction with internal fixation, and external fixation. The concept of bridging plate osteosynthesis has evolved based on scientific insight into bone biology and the importance of blood supply to bone. The use of locked plating is gaining favor in the treatment of certain fractures in adults. However, the role for this technique in the skeletally immature patient has not been described.