The incidence and pattern of fractures in children less than or equal to 12 years of age living in Nottingham, England, have been reviewed. The annual incidence rate is 16/1,000 children. Fractures are rare in those less than 18 months of age, and incidence increases with age. The most common cause of fracture was a fall in or around the home; the incidence rate of fractures after road traffic accidents was similar in all age groups. Fractures of the distal radius and ulna accounted for 35.8% of all fractures seen, with hand fractures the second largest group (14.7%). The most common fracture type was a green-stick fracture (51.6%), and 18.5% of fractures were epiphyseal injuries. Epiphyseal injuries in children less than 5 years of age, were uncommon whereas spiral/oblique fractures were more common. Rotational trauma is more likely to cause a spiral or oblique shaft fracture in a younger child and an epiphyseal fracture in an older child.