This collection of practical Case reports provides a concise guide to managing a wide spectrum of orthopaedic conditions in children. Strategies for determining an optimum management approach to follow in any given situation are provided, and are supported with clinical illustrations and guidelines. Sixty challenging clinical scenarios are presented, from malunion of a tibial fracture to pseudarthrosis of the tibia, after failed primary surgery. Each case is approached in a systematic manner with a background history, key features of physical examination and a series of questions.The questions lead to the goals of surgery, followed by a list of options for the management of each case. The option chosen by the surgeon is then presented, usually with intraoperative, clinical and radiographic illustrations. The majority of cases have substantial follow-up to illustrate the wisdom of the surgical decision-making, the surgical skill employed and the diligent post-operative care and follow-up. Trainees in pediatric orthopaedics and those sitting their final specialty examination will find this Case-based approach helps to anchor both their understanding and retention of key concepts.