The managements of fractures in severely handicapped children are difficult because of their variable complications and thin bone cortex. So there are many discussions for their management. We think that there is an indication of intramedullary fixation for the fracture of femoral shaft; and for the supracondylar fracture of femur, the cylinder cast made of linear polyester polymer may be indicated. There is no indication of traction for the fracture in severely handicapped children because it is very difficult to prevent their decubitus, hypostatic pneumonia and joint contracture which are caused by resting them in a same posture for a long time. There is no indication of plate fixation for the fracture in the patient who has thin bone cortex, very severe involuntary movement and severe muscle hypertonus.
